Songsong Xie1,2, Yan Zhou1, Rongjiong Zheng1, Weiliang Zuo2, Xiaobo Lu1, Yuanzhi Wang3, Yuexin Zhang1
1Department of Infection Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
2The First Hospital of Shihezi University, Shihezi, Xinjiang, China
3School of Medicine, Shihezi University, Shihezi, Xinjiang, China
Tóm tắt
Objective We aimed to describe the clinical characteristics and treatment outcomes of 16 patients with Brucella-induced thrombocytopenia. Methods We assessed 16 patients with Brucella-induced thrombocytopenia between 2012 and 2016 in The First Affiliated Hospital of Xinjiang Medical University. The diagnosis of Brucella-induced thrombocytopenia was ≤100,000 platelets/mm3. Results All patients were men. The most common symptoms of patients were fever (100%), sweating (81.2%), fatigue (75%), and joint pain (25%). The most common signs of physical examinations were an enlarged liver (75%) and enlarged spleen (50%). The lowest thrombocyte count was 2000/mm³ and the highest count was 72,000/mm³. An agglutination test antibody was positive (≥1:160) in 12 (75%) patients with the highest antibody titer of 1:800. Brucella melitensis was isolated from blood cultures in nine (56.3%) patients. All patients were administered antimicrobial agents. The patients’ platelet counts were normal at a follow-up of 12 months. Conclusion Classical brucellosis therapy is adequate for patients with a platelet count > 20,000/mm3. The five-drug regimen of doxycycline + rifampin + platelet transfusions + corticosteroids + intravenous immunoglobulin is recommended for patients when the platelet count is < 10,000/mm3. These findings have important implications for improving treatment outcome in patients with Brucella-induced thrombocytopenia.
