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Free Content Hepatosplenic tuberculosis: a cause of persistent fever during recovery from prolonged neutropenia

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Abstract:

SETTING: Hepatosplenic abscesses in neutropenic patients, especially during the recovery phase, are almost always attributed to fungal infections. We report similar lesions due to Mycobacterium tuberculosis in neutropenic patients in a tertiary care centre in India.

OBJECTIVE: To characterize the features of hepatosplenic tuberculosis in neutropenic patients.

DESIGN: Retrospective comparison of disease pattern and response to treatment of hepatosplenic tuberculosis in febrile neutropenia patients (four of 30 with severe prolonged neutropenia) and in non neutropenic patients diagnosed during the same 12-month period (n = 4, control group).

RESULTS: The disease in the neutropenic patients typically presented during the recovery phase of neutropenia, with ultrasonic abnormalities similar to those seen in hepatosplenic fungal infections. In contrast to the marked organomegaly and typical granulomatous response found in the control group, the disease in the neutropenic patients was characterised by an absence of organomegaly, non-involvement of other sites, poor inflammatory response and a high bacillary load. The initial response to therapy was satisfactory in both groups.

CONCLUSION: Tuberculosis needs to be considered in the diagnostic work-up of hepatosplenic abscesses that occur during the recovery phase of neutropenia.

Keywords: neutropenia; persistent fever; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India 2: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India 3: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India 4: Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Publication date: July 1, 1998

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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