Clinical, Microbiological, and Hematological Characteristics of Pediatric Brucellosis in Saudi Arabia: A Single-Center Retrospective Study

Background and Objectives: Brucellosis remains a significant zoonotic disease in endemic regions such as Saudi Arabia, with children being particularly vulnerable. Pediatric brucellosis often presents with nonspecific symptoms, and hematological abnormalities can serve as important yet underrecognized diagnostic clues. This study aimed to evaluate the demographic, clinical, microbiological, treatment, and hematological characteristics of patients with pediatric brucellosis in the Hail region of Saudi Arabia and to assess the diagnostic value of hematological parameters. Methods: This retrospective observational study included children aged ≤15 years who were diagnosed with brucellosis at a tertiary care hospital in Hail between 2014 and 2025. Demographic, clinical, laboratory, microbiological, and treatment data were analyzed. Hematological parameters were compared between culture-confirmed and non-culture-confirmed brucellosis cases using multivariate and receiver operating characteristic (ROC) analyses. Results: A total of 38 pediatric patients were included (mean age 8.6 years; 57.9% male). Positive culture results were observed in 42.1% of the cases, with Brucella melitensis being the predominant species (68.75%). Fever (89.5%) and bone/joint pain (71.1%) were the most frequent symptoms. Culture-confirmed brucellosis patients had significantly lower hemoglobin levels (10.8 vs. 12.1 g/dL; p = 0.020), white blood cell counts (p = 0.046), and absolute neutrophil counts (p = 0.037). ROC analysis revealed a fair diagnostic performance for hemoglobin (AUROC = 0.695), WBC (0.699), and ANC (0.680). Leukopenia demonstrated high specificity (95.5%) and positive predictive value. Conclusions: Pediatric brucellosis is commonly associated with anemia, leukopenia, and neutropenia. Although no single hematological parameter independently predicts infection, the combination of these abnormalities may support early clinical suspicion, particularly in resource-limited endemic settings.