Recurrent Epistaxis and Bleeding as the Initial Manifestation of Brucellosis

  • Mojtaba Kamali Aghdam Department of Pediatric, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
  • Kambiz Davari Department of Pediatric, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
  • Kambiz Eftekhari Mail Department of Pediatric, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Brucellosis, Epistaxis, Severe thrombocytopenia

Abstract

Severe thrombocytopenia with bleeding is rarely reported in children with brucellosis, and recurrent epistaxis is extremely rare. Brucellosis with hemorrhage should be differentiated from viral hemorrhagic fever, malignancy, and other blood disorders. Bone marrow aspiration (BMA) is mandatory to differentiate from other blood diseases. An 8-year-old boy was admitted with recurrent epistaxis, petechiae and purpura on face and extremities and bleeding from the gums. During the hospitalization, he was febrile and complained of muscle pain. Leukopenias associated with thrombocytopenia were observed. BMA showed to be normal. Among the multiple tests requested, only serum agglutination test (SAT) and 2-MercaptoEthanol test (2-ME) were positive. He was treated with Intravenous immunoglobulin (IVIG) associated with co-trimoxazole and rifampin. Finally, fever subsided, and he was discharged with good condition and normal platelet count. Brucellosis should be a differential diagnosis in patients with fever and bleeding disorders and a history of consumption of unpasteurized dairy, in endemic areas.

References

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Published
2016-04-05
How to Cite
1.
Kamali Aghdam M, Davari K, Eftekhari K. Recurrent Epistaxis and Bleeding as the Initial Manifestation of Brucellosis. Acta Med Iran. 54(3):218-219.
Section
Case Report(s)