[Introducing a case of brucellosis with severe septicemia and pancytopenia]

The most common symptom of brucellosis is osteoarticular manifestation. Urogenital manifestation, hepatitis, CNS and respiratory system involvement and endocarditis are also reported. Mild leucopenia with lymphocytosis, anemia, thrombocytopenia and seldom pancytopenia is seen. A 22-year-old man with fever and chills, abdominal pain and diarrhea came to the hospital. He had headache, malaise, anorexia and dry cough, for 2 weeks. He had no exposure to domestic animals and hadn't consumed any unpasteurized dairy. In lab data, he had leucopenia, relative lymphocytosis, anemia and thrombocytosis, wright = 1/2560, 2ME = 1/1280, Alt=193, AST=446, alkp =375. As long as the patient hadn't have any exposure to domestic animals and also hadn't consumed any unpasteurized dairy, the serology [2ME = 1/80, wright= 1/40] from outside the hospital was repeated and noted results was detected. In endemic areas, in septicemia and pancytopenia or byccytopenia setting we should consider brucellosis in differential diagnosis

[Patients with leukocytosis hospitalized in Labafinejad and Loghman-Hakim hospital, 2003-2004]

Complete blood count [CBC] is one of the frequently required tests in clinics and leukocytosis is the most frequent finding. Few modem studies have enumerated the conditions associated with leukocytosis. In this descriptive study, we evaluated its etiologies in 2 teaching infectious wards from 1382until 1383. 100 inpatients with WBC [white blood cells] count of >/= 10000 cells/mm3 presenting at the Loghman Hakim and Labafinejad Medical center of Shaheed Beheshti Medical University were evaluated. Data were recorded on data sheets and analyzed. We documented infection in 75 patients [75%]. Of these 75 patients, 29 [38.7%] had pneumonia, 19[25.3%] had urinary tract infections, 14[18.7%] had skin and soft tissue infections, 4[5.3%] had bone and joint infections, 3[%4] had CNS infections, 2[2.7%] had cardiovascular infections, 2 [2.7%] had pharyngitis, 1[1.3%] had Gastroenteritis and 1[1.3%%] had intra-abdominal abscess. Non- infection causes of leukocytosis in the 100 patients included physiological stress [11%], medication and drug [5%], hematologic and malignant disorder [2%], and necrosis-inflammation [4%]. 3 patients died without any diagnosis. The mean leukocyte count was 15386 +/- 4747. Infection, especially respiratory tract infection, is a prominent cause of leukocytosis [75%] but non-infectious conditions should also be considered. Despite few malignant cases in this study, malignancy should be ruled out in patients with a very high leukocyte count