Incidental Laboratory Identification of Brucella melitensis in a case with Pancytopenia

Abstract

Brucellosis is a bacterial zoonosis usually associated with exposure to infected animals or their products. Although a significant public health problem in India, exact prevalence and distribution are unknown owing to the imprecision of diagnosis and inadequacy of reporting and surveillance. Although the febrile illness is common, its manifestations are highly variable. Bone marrow suppression and consequent pancytopenia have been rarely reported. We present a case of 50 years old female diagnosed with human brucellosis associated with pancytopenia and non-specific clinical presentation, that was diagnosed incidentally on blood and bone-marrow culture. This was confirmed by serological tests like the standard agglutination test. Culture isolation using automated blood culture (e.g. BacT/ALERT), followed by identification using automated identification systems (e.g. MALDI-TOF and VITEK-2) help to reach accurate and timely diagnosis aiding in the management of the patient.