Iranian Journal of Pathology

Acute Brucellosis with Pancytopenia and Maculopapular Rash

Document Type : Case Reports

Authors

Abasali Omidi 1
Amir Hossein Jafarian 1
Minoo Erfanian 1
Mohammad Javad Yazdanpanah 2
Masoud Sharifian 3

1 Dept. of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Dept. of Dermatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Dept. of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract
    Human brucellosis is common in developing countries and is a multi-system disease with a broad spectrum of clinical manifestations. Cutaneous lesions associated with brucellosis have been rarely reported in the literature. Here we present a case of a 32-year-old man with history of consumption of cheese made from raw milk seen with occurrence of pancytopenia and diffuse maculopapular rash during the course of Brucella infection. Physical examination showed fever, splenomegaly, mild hepatomegaly and pruritic maculopapular exanthema over the trunk, arms and legs. Laboratory tests revealed pancytopenia. Parasitic examinations and serologic tests for syphilis, salmonellosis, rickettsiasis, toxoplasmosis, Epstein-Barr virus, human immunodeficiency virus, and hepatitis B and C viruses were negative. There was no history of drug consumption.The Brucella agglutination test titer was 1/1280   and histological examination of skin biopsy showed lymphohistiocytic perivascular infiltrates in the upper dermis.Lesions were interpreted as Brucellar dermatitis , The patient was subsequently  treated with oral doxycycline and rifampin and was discharged in good health. If there is suspicion of exposure to infected food products, brucellosis should be included in the differential diagnosis of pancytopenia in Brucella-endemic areas; there may be skin lesions other than purpura that can accompany thrombocytopenia.    

Keywords

Brucelloses
Pancytopenias
Skin rash
Iran
Iranian Journal of Pathology
Volume 4, Issue 3 - Serial Number 3
Summer 2009
Pages 133-136

  • Receive Date 28 September 2014

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