Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 218 219 EN 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 Department of Pediatric, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 12 08 2016 01 09 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. https://acta.tums.ac.ir/index.php/acta/article/view/5251 https://acta.tums.ac.ir/index.php/acta/article/download/5251/4769