Brucellosis-related pancytopenia: a diagnostic and therapeutic challenge case report from an endemic region
,
Abstract
Brucellosis, endemic in the Middle East and similar regions, can present with pancytopenia, complicating diagnosis and treatment. We report a 62-year-old female with fever, fatigue, and weight loss. Persistent pancytopenia required prolonged triple antibiotic therapy. Clinicians must consider brucellosis–related pancytopenia and tailor therapy with careful monitoring.
1. O’Callaghan D. Human brucellosis: recent advances and future challenges. Infect Dis Poverty 2020; 9: 101.
2. Mirnejad R, Jazi FM, Mostafaei S, Sedighi M. Epidemiology of brucellosis in Iran: A comprehensive systematic review and meta-analysis study. Microb Pathog 2017; 109: 239-247.
3. Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis 2007; 7: 775-786.
4. Sorsa M, Mamo G, Waktole H, Abunna F, Zewude A, Ameni G. Seroprevalence and Associated Risk Factors of Ovine Brucellosis in South Omo Zone, Southern Ethiopia. Infect Drug Resist 2022; 15: 387-398.
5. Sari I, Altuntas F, Hacioglu S, Kocyigit I, Sevinc A, Sacar S, et al. A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis. Am J Hematol 2008; 83: 334-339.
6. Brucellosis: Background, Pathophysiology, Etiology. Medscape. 2023 [cited 2026 Jun 19]. Available from: https://emedicine.medscape.com/article/213430-overview
7. Uluğ M, Yaman Y, Yapici F, Can-Uluğ N. Clinical and laboratory features, complications and treatment outcome of brucellosis in childhood and review of the literature. Turk J Pediatr 2011; 53: 413-424.
8. Dağ MS, Türkbeyler İ, Gökhan A, Aydınlı M, Savaş MC, Kadayıfçı A. Mesenteric lymphadenitis, pancytopenia, and acute brucellosis. Eur J Ther 2011; 17: 153-154.
9. Ben Lahlou Y, Benaissa E, Maleb A, Chadli M, Elouennass M. Pancytopenia revealing acute brucellosis. ID Cases 2020; 23: e01037.
10. Erkurt MA, Sari I, Gül HC, Coskun O, Eyigün CP, Beyan C. The first documented case of brucellosis manifested with pancytopenia and capillary leak syndrome. Intern Med 2008; 47: 863-865.
11. Maduranga S, Valencia BM, Li X, Moallemi S, Rodrigo C. A systematic review and meta-analysis of comparative clinical studies on antibiotic treatment of brucellosis. Sci Rep 2024; 14: 19037.
12. Huang S, Wang H, Li F, Du L, Fan W, Zhao M, et al. Better efficacy of triple antibiotics therapy for human brucellosis: A systematic review and meta-analysis. PLoS Negl Trop Dis 2023; 17(9): e0011590.
13. Ariza J, Bosilkovski M, Cascio A, Colmenero JD, Corbel MJ, Falagas ME, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med 2007; 4(12): e317.
14. Centers for Disease Control and Prevention (CDC). Estimates human Brucella infections could be four times higher than previously thought. Food Safety. 2023 [cited 2025 Nov 10]. Available from: https://www.food-safety.com/articles/8817-cdc-estimates-human-brucella-infections-could-be-four-times-higher-than-previously-thought
15. Laine CG, Johnson VE, Scott HM, Arenas-Gamboa AM. Global Estimate of Human Brucellosis Incidence. Emerg Infect Dis 2023; 29: 1789-1797.
16. Yagupsky P, Morata P, Colmenero JD. Laboratory diagnosis of human brucellosis. Clin Microbiol Rev 2019; 33(1): e00073-19.
2. Mirnejad R, Jazi FM, Mostafaei S, Sedighi M. Epidemiology of brucellosis in Iran: A comprehensive systematic review and meta-analysis study. Microb Pathog 2017; 109: 239-247.
3. Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis 2007; 7: 775-786.
4. Sorsa M, Mamo G, Waktole H, Abunna F, Zewude A, Ameni G. Seroprevalence and Associated Risk Factors of Ovine Brucellosis in South Omo Zone, Southern Ethiopia. Infect Drug Resist 2022; 15: 387-398.
5. Sari I, Altuntas F, Hacioglu S, Kocyigit I, Sevinc A, Sacar S, et al. A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis. Am J Hematol 2008; 83: 334-339.
6. Brucellosis: Background, Pathophysiology, Etiology. Medscape. 2023 [cited 2026 Jun 19]. Available from: https://emedicine.medscape.com/article/213430-overview
7. Uluğ M, Yaman Y, Yapici F, Can-Uluğ N. Clinical and laboratory features, complications and treatment outcome of brucellosis in childhood and review of the literature. Turk J Pediatr 2011; 53: 413-424.
8. Dağ MS, Türkbeyler İ, Gökhan A, Aydınlı M, Savaş MC, Kadayıfçı A. Mesenteric lymphadenitis, pancytopenia, and acute brucellosis. Eur J Ther 2011; 17: 153-154.
9. Ben Lahlou Y, Benaissa E, Maleb A, Chadli M, Elouennass M. Pancytopenia revealing acute brucellosis. ID Cases 2020; 23: e01037.
10. Erkurt MA, Sari I, Gül HC, Coskun O, Eyigün CP, Beyan C. The first documented case of brucellosis manifested with pancytopenia and capillary leak syndrome. Intern Med 2008; 47: 863-865.
11. Maduranga S, Valencia BM, Li X, Moallemi S, Rodrigo C. A systematic review and meta-analysis of comparative clinical studies on antibiotic treatment of brucellosis. Sci Rep 2024; 14: 19037.
12. Huang S, Wang H, Li F, Du L, Fan W, Zhao M, et al. Better efficacy of triple antibiotics therapy for human brucellosis: A systematic review and meta-analysis. PLoS Negl Trop Dis 2023; 17(9): e0011590.
13. Ariza J, Bosilkovski M, Cascio A, Colmenero JD, Corbel MJ, Falagas ME, et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med 2007; 4(12): e317.
14. Centers for Disease Control and Prevention (CDC). Estimates human Brucella infections could be four times higher than previously thought. Food Safety. 2023 [cited 2025 Nov 10]. Available from: https://www.food-safety.com/articles/8817-cdc-estimates-human-brucella-infections-could-be-four-times-higher-than-previously-thought
15. Laine CG, Johnson VE, Scott HM, Arenas-Gamboa AM. Global Estimate of Human Brucellosis Incidence. Emerg Infect Dis 2023; 29: 1789-1797.
16. Yagupsky P, Morata P, Colmenero JD. Laboratory diagnosis of human brucellosis. Clin Microbiol Rev 2019; 33(1): e00073-19.
| Files | ||
| Issue | Vol 18 No 4 (2026) | |
| Section | Case Report(s) | |
| Keywords | ||
| Brucellosis Pancytopenia Triple therapy Endemic regions Hematologic complications | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Jahani Z, Jahani3Z. Brucellosis-related pancytopenia: a diagnostic and therapeutic challenge case report from an endemic region. Iran J Microbiol. 2026;18(4):633-636.
