An Acute Brucellosis Case Presented with Pancytopenia and Hepatitis

Yıl 2018, Cilt: 45 Sayı: 1, 20 - 25, 12.03.2018

Heval Bilek Ümit Alanbayı Tayibe Bal

https://doi.org/10.5798/dicletip.363935

Öz

Brucellosis is a common zoonotic disease in endemic areas like Turkey. It is an infection that can be
manifested by extensive clinical findings, for this reason it can be difficult to diagnose. In humans,
treatment of the disease requires long-lasting combined antibiotics and appropriate treatment
regimens, but it is often difficult to achieve this success in countries with limited resources.
Therefore, this may be an important economic burden in terms of both cost of treatment and
potential loss of labor in individuals affected by brucellosis. A 23-year-old male patient who was
presented with fever, pancytopenia and hepatitis, was hospitalized with the aim of investigating the
etiology of fever. On laboratory findings supporting the Brusella disease, we started treatment with
the combination of gentamycin and doxycycline to avoid drug-induced hepatotoxic effect. Laboratory
findings were successfully improved while clinical complaints decreased. Brucella disease should be
kept in mind in in endemic areas, concerning patients with abnormal laboratory findings of the
hematopoietic or hepatobiliary system. Taking into consideration the side effects of the medicines
used in the treatment of the disease, effective and least toxic combinations should be selected.

Anahtar Kelimeler

Brucellosis, pancytopenia

Kaynakça

• 1. Galińska EM, Zagórski J. Brucellosis in humans--etiology, diagnostics, clinical forms. Ann Agric Environ Med. 2013;20:233-8.
• 2. de Glanville WA, Conde-Âlvarez R, Moriyon I, et al. Poor performance of the rapid test for human brucellosis in health facilities in Kenya. PLoS Negl Trop Dis. 2017;11:e0005508.
• 3. Kaya O, Avsar K, Zeynep Akçam F. Unusual manifestations of brucellosis. Arch Med Sci. 2011;7:173- 5.
• 4. Sözen TH. Bruselloz. Willke Topçu A, Söyletir G, Doğanay M (eds): Infeksiyon Hastalıkları ve Mikrobiyolojisi, 3rd edn. İstanbul: Nobel Basımevi 2002;636-42.
• 5. Bakri FG, Al-Bsoul NM, Magableh AY,et al. Brucellosis presenting as myelofibrosis: first case report. Int J Infect Dis. 2010;14:e158-60.
• 6. Sakin A, Çelik K, Öztürk S, et al. Bruselloza bağlı bir febril nötropeni olgusu. Med Bull Haseki 2012;50:69-71.
• 7. Buzgan T, Karahocagil MK, Irmak H, et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis. 2010;14:e469- 78.
• 8. Akdeniz H, Irmak H, Demiröz AP. Evaluation of brucellosis cases in Van region of Eastern Anatolia: a-3 year experience. Nagoya Med J.1998;42:101–10.
• 9. Ozer S, Oltan N, Gencer S. Bruselloz: 33 olgunun değerlendirilmesi. Klimik Derg. 1998;11:82-4.
• 10. Mandell GL, Douglas RG, Bennett JE. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. 8th edn. Philadelphia: Churcill Livingstone Elsevier, 2015:2583-2589.
• 11. Keramat F, Hashemi SH. Acute brucellar hepatitis: report of two cases. Avicenna J ClinMicrobInfec. 2015;2:e23908.
• 12. Ulug M, Celen MK, Ayaz C. An unusual presentation of brucello¬sis: acute hepatitis. Braz J Infect Dis. 2010;14:641–2.
• 13. Asef Zadeh M, Allami A, Alavian SM. Acute brucella hepatitis in an urban patient. Hepat Mon. 2009;9:310–3.