SummaryA 12-year-old Saudi boy with falciparum malaria developed profound thrombocytopenia with associated significant bleeding. Immunoglobulin was used to treat this case.

Brucellosis is endemic in Saudi Arabia especially in areas where the local people herd many types of cattle(mainly goats, sheep, camels and cows) Patients acquire the disease by drinking raw milk, eating raw meat or the direct contact with these animals (1-3). It causes a chronic febrile disease with many manifestations. Hematological abnormalities such as anemia, leucopenia and leukocytosis are commonly encountered in affected individuals (4-6). Rarely pancytopenia and disseminate intravascular coagulation are seen. Isolated Brucella-induced thrombocytopenia has been reported mainly in adult affected patients (7, 8). It is extremely rare in children. We present here severe Brucellainduced thrombocytopenia in a child thought to have idiopathic thrombocytopenic purpura (ITP). Once the diagnosis of brucellosis was established and specific treatment (antibiotic combination) was started, the platelets count showed prompt response to this. We advice clinicians in areas where brucellosis is endemic to consider this possibility in children presenting with febrile illnesses and thrombocytopenia.