A PROSPECTIVE STUDY OF BRUCELLOSIS IN CHILDREN: RELATIVE FREQUENCY OF PANCYTOPENIA
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Pancytopenia, endemic brucellosis, fever of unknown origin
Hematological complications in brucellosis are common. Pancytopenia, although mainly reported in adults has also been described in children with brucellosis. This investigation was conducted to estimate the relative frequency of pancytopenia in children with brucellosis. This study was carried out in Al-Khafji region, Saudi Arabia. Sixty patients with brucellosis, were enrolled in the study. At enrollment, the following investigations were performed: CBC, blood culture and BM, aspiration was carried out in all patients with pancytopenia, to exclude malignancy. Obtained results revealed that: out of 60 children with brucellosis, 50 (83%) ingested raw animal milk and 45% had a positive family history of brucellosis. The commonly presenting symptoms and signs included; excessive sweating (68%), bone aches (62%), chills (55%), arthritis (32%), and hepatosplenomegaly. The most commonly detected hematological manifestations included; anemia (in 43%), leukopenia (in 38%) and leukocytosis (in 20%). Meanwhile, pancytopenia was detected in 11 patients (18%). Positive blood culture for brucella was seen in 38% (23 patients). melitensis from 21 patients was cultured in vitro. Out of 9 BM cultures, 3 were positive for B. melitensis and 6 cultures were negative. Out of 11 patients with pancytopenia, 9 patients (82%) presented with bone aches and weakness, 7(64%) presented with sweating and chills, 6(55%) of patients had petechiea and purpura, 5 (46%) had splenomegaly and 5 (46%) had hepatomegaly
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