Pathological Case of the Month | Infectious Diseases | JAMA Pediatrics | JAMA Network
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Special Feature
March 2000

Pathological Case of the Month

Author Affiliations


Arch Pediatr Adolesc Med. 2000;154(3):311-312. doi:

Figure 1. Bone marrow core biopsy specimen shows loose collections of histiocytes (hematoxylin-eosin, original magnification ×400).

Figure 2. Small material (possibly organisms) is apparent on staining (Brown-Brenn, original magnification ×1000).

Figure 3. Small intracellular coccobacillary organisms consistent with Brucella species (Dieterle, original magnification ×1000).

Blood cultures were positive for Brucella melitensis and acute serum titers testing for Brucella species were positive at 1:320 by slide and tube agglutination. The bone marrow aspirate was not cultured; however, Dieterle stains of a bone marrow core specimen revealed small intracellular coccobacillary organisms within the histiocytic aggregates, consistent with Brucella species. No definitive organisms were seen on a tissue Gram stain, although several histiocytes contained small gram-negative material suspicious for bacterial organisms. The patient was treated with a 6-week course of gentamicin and doxycycline with resolution of symptoms and no recrudescence.