A Prospective Study of Brucellosis in Children: Relative Frequency of Pancytopenia

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. The current study was conducted in Al-Khafji joint operation hospital, Saudi Arabia. Sixty patients with brucellosis, were enrolled in the study. Complete blood count (CBC) and blood culture were performed for all cases. Bone marrow (BM) aspiration was considered only in those with pancytopenia. Out of 60 children with brucellosis, 50 (83%) ingested raw animal milk and 27 (45%) had a positive family history of brucellosis. The common presenting symptoms and signs included excessive sweating (68%), bone aches (62%), chills (15%), arthritis (32%), hepatomegaly (18%), and splenomegaly (15%). The main hematological manifestations included anemia (43%), leukopenia (38%) and leukocytosis (20%). Pancytopenia was detected in 11 patients (18%). Blood culture for Brucella was positive in 38% (23 patients). B. melitensis from 21 patients was cultured in vitro. Out of 9 BM aspirate cultures, 3 were positive for B. melitensis. Out of 11 patients with pancytopenia, 9 (82%) patients had bone aches and weakness, 7 (64%) patients had sweating and chills, and 6 (55%) patients had petechiea and purpura. Conclusion: The current study concludes that although pancytopenia is an uncommon complication of brucellosis in children, it does occur. Therefore, brucellosis should be considered in the differential diagnosis of pancytopenia in children, particularly in endemic areas such as Saudi Arabia.