Brucellosis accompanied by haemophagocytic lymphohistiocytosis and multiple splenic abscesses in a patient with depression

BMJ Case Rep. 2018 Mar 27:2018:bcr2017224018. doi: 10.1136/bcr-2017-224018.

Abstract

A 39-year-old woman was being treated for depression in our clinic. She subsequently developed a fever and was diagnosed with pancytopenia and moderate splenomegaly. Laboratory and bone marrow results, including markedly increased serum ferritin levels, suggested haemophagocytic lymphohistiocytosis. CT showed multiple splenic abscesses and ovarian vein thrombosis. All laboratory values returned to normal after treatment for culture-positive brucellosis.

Keywords: haematology (incl blood transfusion); infections; mood disorders (including depression).

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnostic imaging
  • Abscess / drug therapy
  • Abscess / etiology*
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Brucellosis / complications*
  • Brucellosis / diagnosis
  • Brucellosis / drug therapy
  • Citalopram / therapeutic use
  • Depressive Disorder / drug therapy
  • Depressive Disorder / etiology*
  • Diagnosis, Differential
  • Doxycycline / therapeutic use
  • Female
  • Gentamicins / therapeutic use
  • Humans
  • Lymphohistiocytosis, Hemophagocytic / diagnosis
  • Lymphohistiocytosis, Hemophagocytic / drug therapy
  • Lymphohistiocytosis, Hemophagocytic / etiology*
  • Spleen / diagnostic imaging
  • Splenic Diseases / diagnostic imaging
  • Splenic Diseases / drug therapy
  • Splenic Diseases / etiology*
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Antidepressive Agents, Second-Generation
  • Gentamicins
  • Citalopram
  • Doxycycline