Thrombocytopenic Purpura Associated with Brucellosis: Report of 2 Cases and Literature Review

July 8, 2016 at 10:04 am

Clin Infect Dis. (2000) 31 (4): 904-909

Edward J. Young, Ann Tarry, Robert M. Genta, Neslihan Ayden, and Eduardo Gotuzzo

1 Medical, Veterans Affairs Medical Center, Houston, Texas, USA

2 Laboratory Services, Veterans Affairs Medical Center, Houston, Texas, USA

3 Department of Medicine, Baylor College of Medicine, Houston, Texas, USA

4 Department of Pathology, Baylor College of Medicine, Houston, Texas, USA

5 Department of Medicine, University of Texas Medical School at Houston, Houston, Texas, USA

6 Dahiliye Klinigi, Haydarpasa Numune Hastanesi, Istanbul, Turkey

7 Departamento de Medicina, Hospital Nacional Cayetano Heredia, Lima, Peru

Mild hematologic abnormalities are common in the course of human brucellosis; however, they generally resolve promptly with treatment of the disease. Occasionally, thrombocytopenia is severe and can be associated with bleeding into the skin (purpura) and from mucosal sites. We describe 2 patients infected with Brucella melitensis who presented with thrombocytopenic purpura, and we review 41 additional cases from the literature. Patients ranged in age from 2 to 77 years, and both sexes were affected equally. In the majority of cases, examination of the bone marrow revealed abundant megakaryocytes. Possible mechanisms involved in thrombocytopenia include hypersplenism, reactive hemophagocytosis, and immune destruction of platelets. Recognition of this complication is essential, since hemorrhage into the central nervous system is associated with a high mortality rate



Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Metodos diagnosticos, REPORTS, REVIEWS, Sepsis, Update, Zoonosis.

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