Acute brucellosis: a dramatic presentation with septic shock and severe thrombocytopenia
Keywords:
brucellosis, thrombocytopenia, septic shockAbstract
Brucellosis is an endemic zoonosis in Portugal, progressing as
a multisystemic disease with a broad spectrum of clinical manifestations, that can be caused by several species of Brucella, the
most common being B. melitensis. Hematological abnormalities,
including anemia, leukopenia and thrombocytopenia, may be
found during the course of the disease.
The authors describe the case of a 53 year-old man, native of
Cape Verde and residing in Portugal for 25 years, with a condition
of prolonged fever and had a dramatic evolution, with septic shock,
severe thrombocytopenia and hemorrhagic dyscrasia.
The disease was diagnosed as acute brucellosis, and confirmed through blood cultures. Despite the severity of the clinical
situation, the prompt institution of hemodynamic support, blood
transfusion, invasive ventilation and appropriate antibiotics led to
a satisfactory clinical outcome. The diagnosis of brucellosis can
be delayed, particularly when only less common manifestations
are present. In this case it was our purpose to highlight the
importance of maintaining a high degree of suspicion in order to
correctly diagnose cases with less familiar clinical presentations
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