Brucellosis Presenting with Pancytopenia and Massive Splenomegaly: A Case Report from an Endemic Region

^1,3Post Graduate Trainee, Department of General Medicine, Assam Medical College and Hospital, India

²Professor, Department of General Medicine, Assam Medical College and Hospital, India

*Corresponding author: Rajkrishna Sarkar, Post Graduate Trainee, Department of General Medicine, Assam Medical College and Hospital, India, Phone: 08348156679; E-mail: [email protected]

Received Date: December 25, 2025

Published Date: February 06, 2025

Citation: Sarkar R, et al. (2025). Brucellosis Presenting with Pancytopenia and Massive Splenomegaly: A Case Report from an Endemic Region. Mathews J Case Rep. 10(1):198.

Copyrights: Sarkar R, et al. © (2025).

ABSTRACT

Brucellosis is a significant zoonotic disease endemic to the Middle East, Central America, and sub-Saharan Africa, caused by the Gram-negative coccus Brucella. It primarily affects livestock such as cattle, pigs, and sheep, with humans contracting the infection via contaminated aerosols, food, or direct contact with infected animals. The clinical presentation of brucellosis varies but typically includes fever (acute, subacute, or chronic), arthralgia, fatigue, and symptoms stemming from splenic involvement such as hepatosplenomegaly and lymphadenopathy. A case study of a 23-year-old female with severe anemia, fatigue, massive splenomegaly, and a positive Brucella IgG ELISA test illustrates the complexity of diagnosis, which often involves ruling out other conditions through comprehensive laboratory assessments. The patient presented with pancytopenia, microcytic hypochromic anemia, and normal liver enzyme levels alongside previous episodes of intermittent fever. This underscores the diagnostic challenges the disease poses due to its nonspecific symptoms and variable clinical course. Brucellosis is often misdiagnosed, mistaken for primary hematological conditions due to the absence of specific markers. However, timely and accurate diagnosis is crucial, as mismanagement can lead to severe complications. The gold standard for diagnosis remains blood culture, albeit time-consuming. Treatment typically involves a combination of antibiotics, including Rifampicin and Doxycycline, for 6 weeks, with relapses being rare but possible. Despite its capacity to affect various organs, brucellosis primarily impacts the reticuloendothelial system. Awareness of its clinical manifestations and hematological abnormalities is essential in endemic regions to facilitate early identification and management of this often overlooked infectious disease.

Keywords: Brucellosis, Reticuloendothelial System, Rifampicin, Doxycycline.