PMID- 27107528
OWN - NLM
STAT- MEDLINE
DCOM- 20170117
LR  - 20181202
IS  - 1735-9694 (Electronic)
IS  - 0044-6025 (Linking)
VI  - 54
IP  - 3
DP  - 2016 Mar
TI  - Recurrent Epistaxis and Bleeding as the Initial Manifestation of Brucellosis.
PG  - 218-9
AB  - Severe thrombocytopenia with bleeding is rarely reported in children with 
      brucellosis, and recurrent epistaxis is extremely rare. Brucellosis with 
      hemorrhage should be differentiated from viral hemorrhagic fever, malignancy, and 
      other blood disorders. Bone marrow aspiration (BMA) is mandatory to differentiate 
      from other blood diseases. An 8-year-old boy was admitted with recurrent 
      epistaxis, petechiae and purpura on face and extremities and bleeding from the 
      gums. During the hospitalization, he was febrile and complained of muscle pain. 
      Leukopenias associated with thrombocytopenia were observed. BMA showed to be 
      normal. Among the multiple tests requested, only serum agglutination test (SAT) 
      and 2-MercaptoEthanol test (2-ME) were positive. He was treated with Intravenous 
      immunoglobulin (IVIG) associated with co-trimoxazole and rifampin. Finally, fever 
      subsided, and he was discharged with good condition and normal platelet count. 
      Brucellosis should be a differential diagnosis in patients with fever and 
      bleeding disorders and a history of consumption of unpasteurized dairy, in 
      endemic areas.
FAU - Kamali Aghdam, Mojtaba
AU  - Kamali Aghdam M
AD  - Department of Pediatric, School of Medicine, Zanjan University of Medical 
      Sciences, Zanjan, Iran.
FAU - Davari, Kambiz
AU  - Davari K
AD  - Department of Pediatric, School of Medicine, Zanjan University of Medical 
      Sciences, Zanjan, Iran.
FAU - Eftekhari, Kambiz
AU  - Eftekhari K
AD  - Department of Pediatric, School of Medicine, Tehran University of Medical 
      Sciences, Tehran, Iran.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Iran
TA  - Acta Med Iran
JT  - Acta medica Iranica
JID - 14540050R
SB  - IM
MH  - Agglutination Tests
MH  - Brucellosis/*complications/diagnosis
MH  - Child
MH  - Diagnosis, Differential
MH  - Epistaxis/*etiology
MH  - Fever/etiology
MH  - Humans
MH  - Male
MH  - Thrombocytopenia/*etiology
OTO - NOTNLM
OT  - Brucellosis
OT  - Epistaxis
OT  - Severe thrombocytopenia
EDAT- 2016/04/25 06:00
MHDA- 2017/01/18 06:00
CRDT- 2016/04/25 06:00
PHST- 2016/03/25 00:00 [accepted]
PHST- 2016/04/25 06:00 [entrez]
PHST- 2016/04/25 06:00 [pubmed]
PHST- 2017/01/18 06:00 [medline]
PST - ppublish
SO  - Acta Med Iran. 2016 Mar;54(3):218-9.