Journal of Tropical Diseases & Public Health

Acute Brucellosis: A Disease Revealed by Pancytopenia

Abail Boursou^* Department of Biological Sciences, University of Ngaoundere, Ngaoundere, Cameroon
^*Correspondence: Abail Boursou, Department of Biological Sciences, University of Ngaoundere, Ngaoundere, Cameroon, Email:

Received: 02-Aug-2022, Manuscript No. JTD-22-17995; Editor assigned: 05-Aug-2022, Pre QC No. JTD-22-17995 (PQ); Reviewed: 22-Aug-2022, QC No. JTD-22-17995; Revised: 29-Aug-2022, Manuscript No. JTD-22-17995 (R); Published: 05-Sep-2022, DOI: 10.35241/2329-891X.22.10.341

Description

The most common bacterial zoonotic disease is brucellosis. More than 5,00,000 cases are attributed to the infection globally, according to the WHO. Acute brucellosis has frequently been linked to haematological sequelae such moderate anaemia and leukopenia, whereas pancytopenia and thrombocytopenia are less common.

The anthropozoonotic disease brucellosis is well-tolerated in animals. Recurrent abortions in females are to blame for a decline in fecundity in females. Animals with the infection release the germs into the environment through their excrement, and infected females may also produce milk or abortion products.

Animals with the disease can immediately infect a man through the skin, joints, or the air. Following the consumption of contaminated products, contamination can also happen indirectly through food. This is the situation with our afflicted patient who consumed tainted dairy products.

The acute phase of the disease begins with mucocutaneous or intestinal contamination, at which point the bacilli multiply in the lymph nodes, spread through septicemia, and colonise the cells of the reticuloendothelial system. The illness then advances in a subacute phase in some people, with the potential for secondary sites. They can be cutaneous, haematological, gastrointestinal, cardiovascular, genitourinary, and osteo-articular. With or without the identification of an infectious focus, this illness with durations longer than a year is referred to as chronic brucellosis.

The clinical manifestation of the acute phase is characterised by a feeling of unease together with chills, pains, arthromyalgia, and frequently copious sweats, all of which combine to provide the classic picture of the disease of an undulant fever, whose general consequences are occasionally moderate. Anemia and leukopenia are the hallmarks of haematological abnormalities, but pancytopenia is a rather uncommon condition. According to a survey of the literature, the frequency ranged from 3 to 21% depending on the series. Numerous authors just present solitary observations.

Several processes, including hypersplenism, haemophagocytosis, the presence of medullary granulomatosis or medullary hypoplasia, can explain these haematological abnormalities although the pathophysiology of pancytopenia in brucellosis is not fully known. Immune eradication is unusual.

These various systems can occasionally be complicated. The cause of pancytopenia is unknown in 7% of instances. Given the myelogram result, which objectified erythroblastic hyperplasia, hypersplenism is, in our opinion, the most likely explanation. Additionally, according to our observations, a splenomegaly was present but no hepatomegaly. Splenomegaly is present in 35%-60% of brucellosis patients, and in 86%-88% of individuals with pancytopenia and Brucella melitensis, per the data from the literature. Pancytopenia brought on by brucellosis may be explained by the presence of a direct inhibitory effect on proliferating marrow cells or indirectly by the release of mediators that prevent haematopoiesis from activated lymphocytes or parasitized macrophages.

Conclusion

Rifampicin-tetracycline or streptomycin for 6 weeks is the preferred treatment for brucellosis; relapses are uncommon and typically happen in the first year of treatment and are caused by insufficient adherence to the prescribed regimen. The antibiogram's success is not necessary. The majority of strains are susceptible to the antibiotics prescribed for brucellosis. For six weeks, our patient had treatment with rifampicine 900 mg/day and doxycycline 200 mg/day, with a successful clinical outcome.