{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:14:13Z","timestamp":1790730853976,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Brucellosis is a common zoonosis in the Bedouin population of southern Israel. Limited data exist for the rate and risk factors of hematologic complication of brucellosis in children. We assessed anemia, leukopenia, thrombocytopenia and pancytopenia in childhood brucellosis in southern Israel.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Our medical center is the sole hospital in southern Israel. All medical files of brucellosis, 2005\u20132014, identified through positive blood cultures or International Classification of Diseases 9th revision coding with positive serology, were reviewed retrospectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Overall, 511 brucellosis episodes were identified; 42% (N = 214) with \u22651 cytopenia, including 13% (N = 68) anemia, 28% (N = 144) leukopenia, 14% (N = 74) thrombocytopenia and 2% (N = 9) pancytopenia. Overall, 99.8% of episodes were in Bedouin children and 70% in males. In 79% of episodes, blood culture was positive for <jats:italic toggle=\"yes\">Brucella melitensis<\/jats:italic>. Acute infections comprised 84% of all episodes. In univariate analysis, older age (10.49\u2009\u00b1\u20094.81 vs. 9.25\u2009\u00b1\u20094.89 years), fever (92% vs. 78%), positive blood culture (84% vs. 75%) and IgM \u22651:640 levels (50% vs. 39%) were associated with cytopenia. In contrast, arthralgia was associated with noncytopenic episodes. In multivariate analyses, older age (odds ratio = 1.063) and fever (odds ratio = 3.127) were associated with cytopenia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Brucellosis is commonly presented with cytopenia, especially in bacteremic episodes with fever. However, pancytopenia is uncommon and its finding should alert the physician to look for other possible etiologies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/inf.0000000000001900","type":"journal-article","created":{"date-parts":[[2018,1,12]],"date-time":"2018-01-12T20:53:27Z","timestamp":1515790407000},"page":"586-591","source":"Crossref","is-referenced-by-count":16,"title":["Hematologic Manifestations of Brucellosis in Children"],"prefix":"10.1097","volume":"37","author":[{"given":"Naphtali","family":"Justman","sequence":"first","affiliation":[{"name":"The Pediatric Infectious Disease Unit"},{"name":"The Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Israel; Soroka University Medical Center, Beer-Sheva, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yariv","family":"Fruchtman","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit"},{"name":"The Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Israel; Soroka University Medical Center, Beer-Sheva, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Greenberg","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit"},{"name":"The Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Israel; Soroka University Medical Center, Beer-Sheva, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalom","family":"Ben-Shimol","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit"},{"name":"The Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Israel; Soroka University Medical Center, Beer-Sheva, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-20230912","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1056\/NEJMra050570","article-title":"Brucellosis.","volume":"352","author":"Pappas","year":"2005","journal-title":"N Engl J Med"},{"key":"R3-20230912","first-page":"475","article-title":"Human brucellosis outbreak acquired through camel milk ingestion in southern Israel.","volume":"14","author":"Shimol","year":"2012","journal-title":"Isr Med Assoc J"},{"key":"R4-20230912","first-page":"359","article-title":"Recent trends in human brucellosis in Israel.","volume":"13","author":"Anis","year":"2011","journal-title":"Isr Med Assoc J"},{"key":"R5-20230912","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0378-1135(02)00231-6","article-title":"Control of small ruminant brucellosis by use of Brucella melitensis Rev.1 vaccine: laboratory aspects and field observations.","volume":"90","author":"Banai","year":"2002","journal-title":"Vet Microbiol"},{"key":"R6-20230912","doi-asserted-by":"crossref","first-page":"116","DOI":"10.3389\/fcimb.2016.00116","article-title":"A Brucella spp. Isolate from a Pac-Man Frog (Ceratophrys ornata) reveals characteristics departing from classical Brucellae.","volume":"6","author":"Soler-Llor\u00e9ns","year":"2016","journal-title":"Front Cell Infect Microbiol"},{"key":"R7-20230912","doi-asserted-by":"crossref","first-page":"e135","DOI":"10.1086\/523726","article-title":"The many faces of human-to-human transmission of brucellosis: congenital infection and outbreak of nosocomial disease related to an unrecognized clinical case.","volume":"45","author":"Mesner","year":"2007","journal-title":"Clin Infect Dis"},{"key":"R8-20230912","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.ijid.2007.09.004","article-title":"Bacteremia is as unpredictable as clinical manifestations in human brucellosis.","volume":"12","author":"Mantur","year":"2008","journal-title":"Int J Infect Dis"},{"key":"R9-20230912","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1089\/vbz.2012.0997","article-title":"Factors affecting Brucella spp. blood cultures positivity in children.","volume":"13","author":"Apa","year":"2013","journal-title":"Vector Borne Zoonotic Dis"},{"key":"R10-20230912","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1111\/ped.12598","article-title":"Clinical manifestations and laboratory findings of 496 children with brucellosis in Van, Turkey.","volume":"57","author":"Parlak","year":"2015","journal-title":"Pediatr Int"},{"key":"R11-20230912","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/MPH.0000000000000612","article-title":"Hematologic findings in children with Brucellosis: experiences of 622 patients in Eastern Turkey.","volume":"38","author":"Karaman","year":"2016","journal-title":"J Pediatr Hematol Oncol"},{"key":"R12-20230912","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1111\/ped.12688","article-title":"Hematological findings in children with brucellosis.","volume":"57","author":"Aypak","year":"2015","journal-title":"Pediatr Int"},{"key":"R13-20230912","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1089\/vbz.2015.1775","article-title":"Pancytopenia as the initial manifestation of Brucellosis in children.","volume":"15","author":"Karli","year":"2015","journal-title":"Vector Borne Zoonotic Dis"},{"key":"R14-20230912","doi-asserted-by":"crossref","first-page":"e2013011","DOI":"10.4084\/mjhid.2013.011","article-title":"A prospective study of brucellosis in children: relative frequency of pancytopenia.","volume":"5","author":"El-Koumi","year":"2013","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"R15-20230912","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1111\/j.1442-200X.2011.03558.x","article-title":"Retrospective clinical and laboratory evaluation of children with brucellosis.","volume":"54","author":"Okur","year":"2012","journal-title":"Pediatr Int"},{"key":"R16-20230912","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1093\/clinids\/14.1.131","article-title":"Specific antibody profile in human brucellosis.","volume":"14","author":"Ariza","year":"1992","journal-title":"Clin Infect Dis"},{"key":"R17-20230912","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1128\/JCM.02159-08","article-title":"Chronic brucellosis and persistence of Brucella melitensis DNA.","volume":"47","author":"Casta\u00f1o","year":"2009","journal-title":"J Clin Microbiol"},{"key":"R18-20230912","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1111\/j.1651-2227.2007.00271.x","article-title":"Indices of iron deficiency and anaemia in Bedouin and Jewish toddlers in southern Israel.","volume":"96","author":"Urkin","year":"2007","journal-title":"Acta Paediatr"},{"key":"R19-20230912","doi-asserted-by":"crossref","first-page":"3437","DOI":"10.1128\/JCM.37.11.3437-3442.1999","article-title":"Detection of Brucellae in blood cultures.","volume":"37","author":"Yagupsky","year":"1999","journal-title":"J Clin Microbiol"},{"key":"R20-20230912","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1128\/jcm.28.5.1057-1059.1990","article-title":"Isolation, identification, and characterization in Israel of Brucella melitensis biovar 1 atypical strains susceptible to dyes and penicillin, indicating the evolution of a new variant.","volume":"28","author":"Banai","year":"1990","journal-title":"J Clin Microbiol"},{"key":"R21-20230912","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1089\/vbz.2011.0704","article-title":"Limitations of the standard agglutination test for detecting patients with Brucella melitensis bacteremia.","volume":"11","author":"Shemesh","year":"2011","journal-title":"Vector Borne Zoonotic Dis"},{"key":"R22-20230912","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1586\/eri.11.55","article-title":"Implications of laboratory diagnosis on brucellosis therapy.","volume":"9","author":"Al Dahouk","year":"2011","journal-title":"Expert Rev Anti Infect Ther"},{"key":"R23-20230912","doi-asserted-by":"crossref","first-page":"55","DOI":"10.4103\/0974-2727.72149","article-title":"Brucellosis: review on the recent trends in pathogenicity and laboratory diagnosis.","volume":"2","author":"Christopher","year":"2010","journal-title":"J Lab Physicians"},{"key":"R24-20230912","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S0035-9203(01)90241-X","article-title":"Zoonotic infections as causes of hospitalization among febrile Bedouin patients in southern Israel.","volume":"95","author":"Perez-Avraham","year":"2001","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"R25-20230912","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/978-1-4614-0204-6_11","article-title":"Pediatric brucellosis: an (almost) forgotten disease.","volume":"719","author":"Yagupsky","year":"2011","journal-title":"Adv Exp Med Biol"},{"key":"R26-20230912","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1179\/joc.2003.15.1.76","article-title":"Brucella melitensis bacteremia in children: review of 62 cases.","volume":"15","author":"Almuneef","year":"2003","journal-title":"J Chemother"}],"container-title":["Pediatric Infectious Disease Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006454-201806000-00021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T22:47:29Z","timestamp":1694558849000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006454-201806000-00021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1097\/inf.0000000000001900","relation":{},"ISSN":["0891-3668"],"issn-type":[{"value":"0891-3668","type":"print"}],"subject":[],"published":{"date-parts":[[2018,6]]}}}