Brucellosis case presenting with bicytopenia due to hemophagocytic syndrome

Hemophagocytic syndrome is a rare syndrome of excessive inflammation and tissue destruction due to abnormal immune activation and inflammation.Brucellosis is one of the rare causes of hemophagocytosis.Several reports revealed the relationship between hemophagocytosis and brucellosis.In this case, a case of brucellosis presenting with bicytopenia due to hemophagocytic syndrome is presented by blood and bone marrow culture analyses.The Rose Bengal test, Coombs' test and the standard tube agglutination test were performed and were negative.Brucella melitensis was isolated in the blood and bone marrow cultures on the seventh day of incubation.After the diagnosis was confirmed by bone marrow biopsy and blood culture analyses, antibiotic treatment (oral doxycycline 200 mg/day and rifampicin 600 mg/day for 6 weeks) was immediately initiated.Bone marrow aspiration biopsy has shown platelets, neutrophils, and lymphocytes phagocytosed by macrophages.Peripheral blood counts of the patient returned to normal levels after 2 weeks of antibiotic treatment of brucellosis.Antibiotic treatment was stopped after 6 weeks of therapy once patient's complaints have resolved.