Abstract
BackgroundBrucellosis is an important cause of morbidity and mortality in patients living in areas that are endemic for the infection.Case PresentationA 20 years old Saudi male was diagnosed to have severe aplastic anemia at King Faisal Specialist Hospital and Research Centre in Riyadh in April 2006. One hundred and twelve days following his successful allogeneic hematopoietic stem cell transplant, he presented with pyrexia in addition to neutropenia and mild thrombocytopenia. Brucella serology was strongly positive and blood cultures grew Brucella melitensis. The bacteremic episode of brucellosis was successfully treated with streptomycin, doxycyclin and ciprofloxacin at the outpatient clinic. To our knowledge, this is the first case of a naturally occurring Brucella infection complicated by Brucella bacteremia in a recipient of hematopoietic stem cell transplant.ConclusionBrucellosis may cause systemic infections, complicated bacteremias and serious morbidity in immunocompromised patients living in countries that are endemic for the infection. It should be considered as a possible cause of fever and pancytopenia in hematopoietic stem cell transplant recipients living in these geographical locations. Nevertheless, the infection is curable provided the diagnosis is made early and an appropriate antimicrobial therapy is promptly initiated.
Highlights
Brucellosis is an important cause of morbidity and mortality in patients living in areas that are endemic for the infection.Case Presentation: A 20 years old Saudi male was diagnosed to have severe aplastic anemia at King Faisal Specialist Hospital and Research Centre in Riyadh in April 2006
Brucellosis may cause systemic infections, complicated bacteremias and serious morbidity in immunocompromised patients living in countries that are endemic for the infection
It should be considered as a possible cause of fever and pancytopenia in hematopoietic stem cell transplant recipients living in these geographical locations
Summary
Brucellosis can affect immunocompromised hosts as well as healthy individuals. Brucellosis should always be included in the differential diagnosis of febrile neutropenia and pancytopenia in immunocompromised hosts living in geographic areas that are endemic for brucellosis. Specific investigations including blood cultures for Brucella and Brucella serology should be taken and appropriate antimicrobial therapy should be initiated promptly. Brucellosis is curable and is usually responsive to antimicrobial ther-. Aplastic anemia; hematopoietic stem cell transplant; Brucella bacteremia; graft versus host disease; trimethoprim – sulphamethoxazole; pyrexia of unknown origin. Osoba AO, Balkhy H, Memish Z, Khan MY, Al-Thagafi A, Alshareef B, AlMowallad A, Oni GA: Diagnostic value of Brucella ELISA IgG and Ig M in bacteremic and non-bacteremic patients with brucellosis.
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