Hematologic Manifestations of Brucellosis in Children

Naphtali Justman, Yariv Fruchtman, David Greenberg, Shalom Ben-Shimol

    Research output: Contribution to journalArticlepeer-review

    11 Scopus citations


    Background: Brucellosis is a common zoonosis in the Bedouin population of southern Israel. Limited data exist for the rate and risk factors of hematologic complication of brucellosis in children. We assessed anemia, leukopenia, thrombocytopenia and pancytopenia in childhood brucellosis in southern Israel. Methods: Our medical center is the sole hospital in southern Israel. All medical files of brucellosis, 2005–2014, identified through positive blood cultures or International Classification of Diseases 9th revision coding with positive serology, were reviewed retrospectively. Results: Overall, 511 brucellosis episodes were identified; 42% (N = 214) with ≥1 cytopenia, including 13% (N = 68) anemia, 28% (N = 144) leukopenia, 14% (N = 74) thrombocytopenia and 2% (N = 9) pancytopenia. Overall, 99.8% of episodes were in Bedouin children and 70% in males. In 79% of episodes, blood culture was positive for Brucella melitensis. Acute infections comprised 84% of all episodes. In univariate analysis, older age (10.49 ± 4.81 vs. 9.25 ± 4.89 years), fever (92% vs. 78%), positive blood culture (84% vs. 75%) and IgM ≥1:640 levels (50% vs. 39%) were associated with cytopenia. In contrast, arthralgia was associated with noncytopenic episodes. In multivariate analyses, older age (odds ratio = 1.063) and fever (odds ratio = 3.127) were associated with cytopenia. Conclusions: Brucellosis is commonly presented with cytopenia, especially in bacteremic episodes with fever. However, pancytopenia is uncommon and its finding should alert the physician to look for other possible etiologies.

    Original languageEnglish
    Pages (from-to)586-591
    Number of pages6
    JournalPediatric Infectious Disease Journal
    Issue number6
    StatePublished - 1 Jun 2018


    • Anemia
    • Brucella melitensis
    • Brucellosis
    • Children
    • Pancytopenia
    • Thrombocytopenia

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Microbiology (medical)
    • Infectious Diseases


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