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Four cases of sickle cell anaemia accompanied by brucellosis causing pain crisis

Abstract number: P1859

Turunc T., Demiroglu Y., Kizilkilic E., Aliskan H., Colakoglu S., Ozdogu H., Arslan H.

Objectives: Pain crisis which frequently appears in cases of sickle cell anaemia causes such complaints as severe pain in the extremities and the back and fever at the beginning. Among the factors which trigger pain crisis are extreme changes in temperature and stress. However, the cause is usually unknown. The aim of this study was to determine clinical features, laboratory results and treatment outcomes of sickle cell anaemia accompanied by brucellosis causing pain crisis. To our knowledge, there have not been such cases in the literature.

Methods: Four patients with sickle cell anaemia diagnosed with acute brucellosis when under supervision for pain crisis in Haematology Department between June 2004 and September 2006 were consecutively enrolled in the study.

Results: Out of four patients, two were male and two were female. The patients were aged 26–46 years. All patients had a history of consumption of unpasteurised milk and milk products. The most frequent complaints were fever (4/4), severe joint pain (3/4) and severe muscle pain (3/4). Brucellosis agglutination test was positive at 1/1280 in all patients and blood cultures showed Brucella melitensis in two patients. Only one patient had focal organ involvement in the form of epidural abscess in the lumbar region. This patient was administered doxycycline 200 mg/day (p.o.), rifampicin 600 mg/day (p.o.) and cotrimoxazole 800 mg/day (p.o.) for 6 months. The others patients were treated doxycycline 200 mg/day (p.o.), rifampicin 600 mg/day (p.o.) for 45 days. All patients recovered following completion of the medical treatment. The patient with epidural abscess had a relapse about 8 months after completion of the treatment. The other patients had no relapses.

Conclusion: High fever and severe joint pain are the most frequent signs of pain crisis in sickle cell anaemia. However, those symptoms may indicate acute brucellosis as in our series. Therefore, brucellosis should be kept in mind in patients with sickle cell anaemia presenting with high fever in regions where brucellosis is endemic and appropriate tests and blood cultures should be performed for the diagnosis of brucellosis.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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