First Pediatric Case Report of an Acute Liver Failure as a Complication of Brucellosis

摘要

Acute liver failure (ALF) is a critical illness in children, with different etiologies, including infections. Brucellosis is a worldwide widespread zoonosis. In many developing countries, brucellosis is endemic, and it is underdiagnosed and under-reported [1]. Brucellosis infection affects many organ systems. Here, we describe the case of a 14-year-old male patient with ALF due to brucellosis. As far as we know, this is the first report of ALF in a child. We emphasize that brucellosis should be considered in the differential diagnosis of ALF, especially in endemic areas. CASE PRESENTATION A 14-year-old male patient was admitted to Dr Behcet Uz Child Disease and Surgery Training and Research Hospital with 3 days of persistent fever and 15 days of weakness, decreased appetite, abdominal pain, vomiting, knee pain, and jaundice. His body temperature, blood pressure, heart rate, respiratory rate, and oxygen saturation were within normal ranges for his age. A neurological examination was normal. He was pale and had mucocutaneous jaundice. Abdominal palpation revealed no tenderness, but hepatomegaly (3 cm below the costal margin) was detected. There were no other physical findings of note. The patient’s hemoglobin was 13.5 g/dL, the white blood cell count was 6140/mm3, and the platelet count was 292 000/L. The erythrocyte sedimentation rate was 2 mm/h. The prothrombin time (PT), partial thromboplastin time, and D-dimers were within normal limits, as were renal function tests, sodium, potassium, total proteins, and albumin.