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Gaziantep Med J. 2011; 17(3): 153-154

Mesenteric lymphadenitis, pancytopenia, and acute brucellosis

Muhammed Sait Dağ, İbrahim Türkbeyler, Azize Gökhan, Musa Aydınlı, Mehmet Cemil Savaş, Abdurrahman Kadayıfçı.

Brucellosis is a zoonotic infection caused by gram (-) Brucella species and involves multipl organ systems. It usually presents with fever and constitutional symptoms but atypical presentations may also occur. Acute brucellosis presenting with pancytopenia and abdominal pain due to mesenteric lymphadenitis have been published as case reports. A 71-year-old woman admitted to our clinic with severe abdominal pain mimicking acute abdomen, fever, constipation and weight loss for last three weeks. In complete blood count, there was serious pancytopenia. Although Wright agglutination test was negative, Brucella species were isolated in blood culture. Combined treatment of rifampicin 600 mg/day and doxycycline 200 mg/day was started. There were mesenteric enlarged lymph nodes detected in the computerized tomography and the abdominal pain is thought to be related with this mesenteric lymphadenitis. The clinical and laboratory findings were dramatically improved with the treatment and it was continued for six weeks. In conclusion, although the presentation of acute brucellosis with mesenteric lymphadenitis and pancytopenia is rare, it must be considered in patients such in endemic areas.

Key words: Acute brucellosis; mesenteric lymphadenitis; pancytopenia

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