Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2023; 11(21): 5187-5192
Published online Jul 26, 2023. doi: 10.12998/wjcc.v11.i21.5187
Brucellosis presenting with pancytopenia and hearing loss: A case report
Xing Chen, Feng-Bo Yang, Jian-Ying Liang
Xing Chen, Jian-Ying Liang, Department of Infection, Nanchong Central Hospital, Nanchong 637000, Sichuan Province, China
Feng-Bo Yang, Department of Otolaryngology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: Chen X and Liang JY treated the patient, and made the clinical diagnosis; Chen X and Yang FB wrote and revised the manuscript; Yang FB was co-first author; All authors have read and approved the manuscript.
Informed consent statement: Written informed consent was obtained from individual participants.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xing Chen, MM, Department of Infection, Nanchong Central Hospital, Changchunteng Yard, Qingfeng South Road, Nanchong 637000, Sichuan Province, China. 505647754@qq.com
Received: May 24, 2023
Peer-review started: May 24, 2023
First decision: June 13, 2023
Revised: June 26, 2023
Accepted: July 7, 2023
Article in press: July 7, 2023
Published online: July 26, 2023
Processing time: 63 Days and 18.1 Hours
Abstract
BACKGROUND

Brucellosis is one of the most common zoonotic infectious diseases in the world, with approximately 500000 new cases of human brucellosis diagnosed each year. Brucellosis can simulate various multi-system diseases, presenting atypical symptoms. Very few brucellosis cases with pancytopenia accompanied by a severe hearing loss have been reported. In the literature review, we could find only one similar case reported in the past. Moreover, this disease is easily misdiagnosed as a blood system disease leading to delayed treatment. Thus, it is important to improve clinicians' awareness of this disease.

CASE SUMMARY

A 64-year-old woman presented with dizziness and fatigue, accompanied by pancytopenia and severe hearing loss. Brucella melitensis was identified on blood culture. Anti-infective therapy with rifampicin (900 mg/d) and doxycycline (100 mg twice a day) was prescribed for 4 mo along with ceftriaxone 2 g/d for 1 mo. The patient showed a good response to antibiotic therapy. Her blood counts returned to normal followed by significant improvement in hearing.

CONCLUSION

Brucellosis should be considered in the differential diagnosis of patients presenting with pancytopenia and hearing loss.

Keywords: Brucellosis; Pancytopenia; Hearing loss; Neurobrucellosis; Case report

Core Tip: Brucellosis is a zoonotic disease that has recently shown a resurgence across the world. Brucellosis can affect multiple systems in the human body and the clinical manifestations may be atypical, making the diagnosis more difficult. In this article, we report a rare case of brucellosis presenting with pancytopenia and severe hearing loss. A series of tests ruled out a blood disorder, Brucella melitensis was identified on blood culture. The patient recovered well without sequelae after receiving anti-infective medication with rifampicin, doxycycline, and ceftriaxone. This report may help improve the understanding of brucellosis among clinicians in non-endemic areas.