Abstract
Brucellosis is a zoonotic infection caused by gram (-) Brucella species and involves multiple organ systems. It usually presents with fever and constitutional symptoms, but atypical presentations may also occur. Acute brucellosis presenting with pancytopenia and abdominal pain due to mesenteric lymphadenitis have been published as case reports. A 71-year-old woman admitted to our clinic with severe abdominal pain mimicking acute abdomen, fever, constipation and weight loss for last three weeks. In complete blood count, there was serious pancytopenia. Although Wright agglutination test was negative, Brucella species were isolated in blood culture. Combined treatment of rifampicin 600 mg/day and doxycycline 200 mg/day was started. There were mesenteric enlarged lymph nodes detected in the computerized tomography and the abdominal pain was thought to be related with this mesenteric lymphadenitis. The clinical and laboratory findings were dramatically improved with the treatment and it was continued for six weeks. In conclusion, although the presentation of acute brucellosis with mesenteric lymphadenitis and pancytopenia is rare, it must be considered in patients such in endemic areas.
Keywords
References
- 1. Young EJ. Brucella species. In: Mandell GL, Bennett E, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 5th ed. Philadelphia: Churchill Livingstone 2000; 2386-2393.
- 2. Galanakis E, Bourantas KL, Leveidiotou S, Lapatsanis PD. Childhood brucellosis in north-western Greece: a retrospective analysis. Eur J Pediatr 1996;155(1):1-6.
- 3. Akdeniz H, Irmak H, Seckinli T, Buzgan T, Demiröz AP. Hematological manifestations in brucellosis cases in Turkey. Acta Med Okayama 1998;52(1):63-5.
- 4. Ablin J, Mevorach D, Eliakim R. Brucellosis and the gastrointestinal tract. The odd couple. J Clin Gastroenterol 1997;24(1):25-9.
- 5. Bodur H, Çolpan A, Erbay A, Akıncı E, Eren S. Akut batın tablosunu taklit eden bruselloz olgusu. Klimik Dergisi 2003;16(1):41-2.
- 6. Sozen TH. Bruselloz. In: Willke Topcu A, Soyletir G, Doğanay M, eds. Enfeksiyon Hastalıkları ve Mikrobiyolojisi. 3. baskı, İstanbul: Nobel Tıp Kitabevleri 2008: 897-908.
- 7. Chia JK, Kennedy CA, Ponsillo MA. Fever, hepatosplenomegaly, and pancytopenia in a 39-year-old hispanic woman. Rev Infect Dis 1990;12(4):636-43.
- 8. Jayakumar RV, Al-Aska AK, Subesinghe N, Wright SG. Unusual presentation of culture positive brucellosis. Postgrad Med J 1988;64(748):118-20.
- 9. Fernandez MD, Garcia JL, Garcia FD, Fernandez MT. Brucella acute abdomen mimicking appendicitis. Am J Med 2000;108(7):599-600.
- 10. al-Eissa YA, Assuhaimi SA, al-Fawaz IM, Higgy KE, al-Nasser MN, al-Mobaireek KF. Pancytopenia in children with brucellosis: clinical manifestations and bone marrow findings. Acta Haematol 1993;89(3):132-6.
Abstract
Brusellozis, gram (-) Brucella cinsi bakterilerin neden olduğu, birçok organ ve sistemi tutabilen zoonotik bir infeksiyondur. Brusellozis sıklıkla ateş ve konstitüsyonel semptomlarla ortaya çıkmakla birlikte atipik klinik bulgularla da prezente olabilir. Pansitopeni ve mezenterik lenfadenite bağlı karın ağrısıyla prezentasyon, vaka sunumlarıyla bildirilmiştir. Yetmiş bir yaşında bayan hasta 3 haftadır olan ve akut batını taklit eden karın ağrısı, ateş, kabızlık, kilo kaybı şikayetleri ile kliniğimize başvurdu. Tam kan sayımında belirgin pansitopeni vardı. Wright aglütinasyon testi negatif olmasına rağmen, kan kültüründe Brucella türleri üredi. Rifampisin 600 mg/gün ve doksisiklin 200 mg/gün kombine tedavisi başlandı. Yaygın karın ağrısı batın bilgisayarlı tomografisinde saptanan mezenterik lenfadenite bağlandı. Tedaviyle klinik ve laboratuvar bulguları dramatik olarak düzeldi, tedavi 6 haftaya tamamlandı. Sonuç olarak; brusellozisde mezenterik lenfadenit ve pansitopeni birlikteliği nadir karşılaşılan bir durum olmakla birlikte, özellikle brusellozisin endemik olduğu bölgelerde, benzer hastalarda göz önünde bulundurulmalıdır.
References
- 1. Young EJ. Brucella species. In: Mandell GL, Bennett E, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 5th ed. Philadelphia: Churchill Livingstone 2000; 2386-2393.
- 2. Galanakis E, Bourantas KL, Leveidiotou S, Lapatsanis PD. Childhood brucellosis in north-western Greece: a retrospective analysis. Eur J Pediatr 1996;155(1):1-6.
- 3. Akdeniz H, Irmak H, Seckinli T, Buzgan T, Demiröz AP. Hematological manifestations in brucellosis cases in Turkey. Acta Med Okayama 1998;52(1):63-5.
- 4. Ablin J, Mevorach D, Eliakim R. Brucellosis and the gastrointestinal tract. The odd couple. J Clin Gastroenterol 1997;24(1):25-9.
- 5. Bodur H, Çolpan A, Erbay A, Akıncı E, Eren S. Akut batın tablosunu taklit eden bruselloz olgusu. Klimik Dergisi 2003;16(1):41-2.
- 6. Sozen TH. Bruselloz. In: Willke Topcu A, Soyletir G, Doğanay M, eds. Enfeksiyon Hastalıkları ve Mikrobiyolojisi. 3. baskı, İstanbul: Nobel Tıp Kitabevleri 2008: 897-908.
- 7. Chia JK, Kennedy CA, Ponsillo MA. Fever, hepatosplenomegaly, and pancytopenia in a 39-year-old hispanic woman. Rev Infect Dis 1990;12(4):636-43.
- 8. Jayakumar RV, Al-Aska AK, Subesinghe N, Wright SG. Unusual presentation of culture positive brucellosis. Postgrad Med J 1988;64(748):118-20.
- 9. Fernandez MD, Garcia JL, Garcia FD, Fernandez MT. Brucella acute abdomen mimicking appendicitis. Am J Med 2000;108(7):599-600.
- 10. al-Eissa YA, Assuhaimi SA, al-Fawaz IM, Higgy KE, al-Nasser MN, al-Mobaireek KF. Pancytopenia in children with brucellosis: clinical manifestations and bone marrow findings. Acta Haematol 1993;89(3):132-6.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | April 1, 2011 |
| Published in Issue | Year 2011 Volume: 17 Issue: 3 |