Brucella-induced Thrombocytopenia and Bleeding

Mild anemia and leukopenia are the most common hematologic problems of acute brucellosis. Mild thrombocytopenia also occurs, but severe cases are uncommon. Thrombocytopenia occurs because of bone marrow suppression, hypersplenisem, hemophagocytosis, and immunologic destruction of the cells or disseminated intravascular coagulation. In endemic areas, hemorrhagic fevers, hematologic malignancies, as well as idiopathic thrombocytopenic purpura should be considered as differential diagnoses for complicated brucellosis. Thrombocytopenia and bleeding can be improved with antibiotic and hematologic supportive therapy whereas in severe cases corticosteroid therapy or splenectomy might be necessary.