scholarly journals Unusual Manifestation of Extrapulmonary Tuberculosis

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Aisha A. Alghamdi ◽  
Faiza S. Awan ◽  
Iqbal H. Maniyar ◽  
Naif A. Alghamdi
Keyword(s):  
Bone Marrow ◽  
Extrapulmonary Tuberculosis ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Leukemoid Reaction ◽  
Unusual Manifestation ◽  
Pyrexia Of Unknown Origin ◽  
Antituberculosis Treatment ◽  
History Of ◽  
Severe Pancytopenia

Though commonly encountered, extrapulmonary tuberculosis (TB) can sometimes present with variable clinical picture intricating the diagnosis (Avasthi et al., 2010). The nonspecific symptoms include pyrexia of unknown origin, hepatosplenomegaly, lymphadenopathy, meningitis, and, rarely, variety of hematological abnormalities, namely, anemia, pancytopenia, and leukemoid reaction (Avasthi et al., 2010). When it presents with bone marrow (BM) involvement, prognosis is usually poor (Avasthi et al., 2010, Qasim et al., 2003, and Singh et al., 2001). We, hereby, report a case of extra-pulmonary TB with a six-month history of fever associated with dizziness, fatigability, and cough. During the hospital stay, the patient showed a spectrum of interesting hematological findings, including severe pancytopenia on peripheral smear, necrotizing caseating granulomas consistent with TB on bone marrow examination. The patient showed a good clinical as well as hematological response to antituberculosis treatment. This paper highlights the significance of a hematological picture in the final confirmation of TB, which may otherwise be passed off as nutritional or other unrelated causes.

scholarly journals Value of Bone marrow Examination in Pyrexia of unknown origin

2013 ◽  
Vol 3 (6) ◽  
pp. 447-451 ◽  
Author(s):  
A Jha ◽  
R Sarda
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Common Finding ◽  
Morphological Examination ◽  
Diagnostic Dilemma ◽  
Serological Tests ◽  
Pyrexia Of Unknown Origin ◽  
Diagnostic Modalities

Background: Pyrexia of unknown origin is a common diagnostic dilemma. Series of diagnostic modalities are required to arrive at diagnosis. Bone marrow examination is one of the common tests implicated in the diagnosis in combination with other diagnostic modalities. Present study has attempted to explore the causes of pyrexia of unknown origin based on bone marrow morphological study. Materials and Methods: In a one year prospective study conducted at Manipal Teaching Hospital, Pokhara, Nepal; bone marrow aspiration and biopsy was performed and evaluated morphologically, in 57 patients fulfilling the criteria of classic pyrexia of unknown origin. Results: In 42% cases; specific diagnosis could be made and hematological neoplasm was the most common finding followed by megaloblastic anemia, hypoplastic anemia and one case each of hemophagocytosis, malaria and tuberculosis. Acute leukemia was the most frequently encountered hematological malignancy followed by multiple myeloma, chronic myeloid leukemia, essential thrombocythemia and myelodysplastic syndrome. Conclusion: Morphological examination of bone marrow has important role in diagnosis of pyrexia of unknown origin. However, yield of diagnosis can be increased if it is combined with other diagnostic modalities including radiological, microbiological and serological tests. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8991 Journal of Pathology of Nepal (2013) Vol. 3, 447-451

scholarly journals Myeloproliferative Neoplasm with Prominent Eosinophilia

2014 ◽  
Vol 31 (3) ◽  
pp. 162-167
Author(s):  
S Giti ◽  
MN Bhuiyan ◽  
MR Hossain ◽  
MS Islam ◽  
F Ahmed ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Intensive Care ◽  
Haematological Malignancy ◽  
Past History ◽  
Myeloproliferative Neoplasm ◽  
Oral Prednisolone ◽  
Bone Marrow Examination ◽  
Atrial Thrombus ◽  
Care Facilities ◽  
History Of

The patient, a young soldier aged 36 years having past history of malaria, was admitted in CMH Dhaka on 17 August 2011 as a transferred case from CMH Saidpur and died on 22 August 2011. The deceased was admitted in CMH Saidpur on 05 August 2011 with high fever for 05 days along with generalized joint and muscle pain. In spite of all available treatment the patient was deteriorating and he was then transferred to CMH Dhaka. At that time the patient was febrile, dehydrated and toxic with lymphadenopathy, extremely tender joints and muscles. The patient rapidly developed acute kidney failure and gradually developed features of DIC. His bone marrow examination revealed dyserythropoiesis with predominantly eosinophilic granulopoiesis, suggestive of myeloproliferative neoplasm with prominent eosinophilia. The patient was treated with injectable antibiotics, antimalarial and oral prednisolone with all intensive care facilities. Ultimately all attempts were proved unsuccessful and he died on 22 August 2011 at 1700 hrs. On autopsy the deceased had intra atrial thrombus and possibly that was the immediate cause of death. A haematological malignancy, myeloproliferative neoplasm with prominent eosinophilia, can very well produce such a fatal condition. DOI: http://dx.doi.org/10.3329/jbcps.v31i3.20985 J Bangladesh Coll Phys Surg 2013; 31: 162-167

Utility of bone marrow examination for workup of fever of unknown origin in patients with HIV/AIDS

2015 ◽  
Vol 68 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Andrés E Quesada ◽  
Ashok Tholpady ◽  
Audrey Wanger ◽  
Andy N D Nguyen ◽  
Lei Chen
Keyword(s):  
Bone Marrow ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Hiv Aids

scholarly journals Retrospective Evaluation of Pediatric Patients With Abdominal Tuberculosis: A Single Center Experience

2020 ◽  
Vol 54 (4) ◽  
pp. 204-211
Author(s):  
Sevgi Yaşar Durmuş ◽  
Gönül Tanır ◽  
Ayşe Seçil Ekşioğlu ◽  
Türkan Aydın Teke ◽  
Yasemin Taşçı Yıldız ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Extrapulmonary Tuberculosis ◽  
Abdominal Tuberculosis ◽  
Diagnostic Methods ◽  
Mycobacterium Tuberculosis Infection ◽  
Reactive Protein ◽  
Single Center Experience ◽  
Antituberculosis Treatment ◽  
History Of ◽  
The Mean

Objective: Abdominal tuberculosis is a kind of extrapulmonary tuberculosis that can usually occur during the lymphohematogenous spread of first Mycobacterium tuberculosis infection, develop by neighborhood from an abdominal focus or a mesenteric lymph node. The aim of this study is to evaluate pediatric cases diagnosed with abdominal tuberculosis. Material and Methods: Between 2012-2018, seven patients diagnosed with abdominal tuberculosis through patients who diagnosed with extrapulmonary tuberculosis in our hospital, were included in study. Demographic and clinical characteristics, diagnostic methods, commenced treatments and clinical follow up of patients were listed from medical records. Results: Of patients, four were female. The mean age was 144.2 ± 42.7 months. None of the patients had a history of tuberculosis contact. The median complaint time was 20 days (5-180). The most frequent complaint was abdominal pain and the most frequent physical examination finding was abdominal tenderness. Mean white blood cell count was 9.26 x 103 ± 4.77 x 103 μ/L, C reactive protein level: 79.9 ± 54.9 mg/dL, erytrocyte sedimentation rate: 45 ± 30 mm/h. Tuberculin skin test was positive in two patients, interferon gamma releasing assay was positive in three patients, and in two patients, both tests were positive. There were findings suggesting tuberculosis on pulmonary imaging in five patients and abdominal imaging in all patients. Histopathological examination of the specimens of six patients revealed findings consistent with tuberculosis. The presence of M. tuberculosis was confirmed microbiologically in clinical specimens taken from three patients. The most common abdominal tuberculosis type was mesenteric lymphadenitis. The mean time from admission to diagnosis was 15 ± 12.8 days. All patients recieved antituberculosis treatment. Conclusion: Abdominal tuberculosis should be kept in mind, in patients presenting with abdominal complaints lasting more than five days. Ultrasonography and computed tomography are useful to determine abdominal tuberculosis type. The disease can be sucsessfully treated with standart antituberculosis treatment.

scholarly journals Granulomatosis with Polyangiitis Presenting as Pyrexia of Unknown Origin, Leukocytosis, and Microangiopathic Haemolytic Anemia

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Sima Terebelo ◽  
Iona Chen
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Immunosuppressive Treatment ◽  
Kidney Injury ◽  
Unknown Origin ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
High Dose ◽  
Normal Range ◽  
Pyrexia Of Unknown Origin ◽  
History Of ◽  
Haemolytic Anemia

A 66-year-old woman presented to the Emergency Department with a florid sepsis-like picture, a two-week history of fever, relative hypotension with end organ ischemia (unexplained liver enzyme and troponin elevations), and nonspecific constitutional symptoms. She was initially found to have a urinary tract infection but, despite appropriate treatment, her fever persisted and her white blood cell count continued to rise. During her hospitalization the patient manifested leukocytosis to 47,000 WBC/μL, ESR 67 mm/hr (normal range 0–42 mm/hr), CRP 17.5 mg/dL (normal range 0.02–1.20 mg/dL), and microangiopathic haemolytic anemia, with declining haemoglobin and haematocrit. An infectious aetiology was not found despite extensive bacteriologic studies and radiographic imaging. The patient progressed to acute kidney injury with “active” urinary sediment and proteinuria. Kidney biopsy results and serological titres of myeloperoxidase positive perinuclear-antineutrophil cytoplasmic antibodies (MPO+ p-ANCA) led to a diagnosis of granulomatosis with polyangiitis. Immunosuppressive treatment with high dose methylprednisolone and rituximab led to resolution of the leukocytosis and return of the haemoglobin and haematocrit values toward normal without further signs of hemolysis.

scholarly journals UNCOMMON PRESENTATION OF A COMMON DISEASE AS PUO

2020 ◽  
pp. 51-52
Author(s):  
Y.V.S. Prabhakar ◽  
Ponnaganti Vasundhara
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Unknown Origin ◽  
Common Disease ◽  
Peripheral Smear ◽  
Laboratory Findings ◽  
Pyrexia Of Unknown Origin ◽  
Uncommon Presentation ◽  
Blood Smears ◽  
Peripheral Blood Smears

We report a case of pyrexia of unknown origin in a 35 yr old male . He presented to us with fever since 2 months which was associated with chills and rigor . He is non alcoholic , non smoker . Mild Hepatosplenomegaly was found on initial physical examination. Before he was referred to our hospital, he was investigated in outside hospital . The serial Rapid Diagnostic Test and microscopic peripheral blood smears for plasmodium were negative . He was treated symptomatically . In view of non subsiding fever patient was referred to higher centre . He presented to our institute for further evaluation . His laboratory findings found pancytopenia. Bone marrow aspiration(BMA) was done. BMA showed Gametocytes of P. falciparum. The presence of gametocytes of P.Falciparum in the bone marrow ,not in peripheral smear and presenting as PUO is rare .

scholarly journals Bone marrow granuloma in a child with pyrexia of unknown origin: A clue for diagnosis of brucellosis

2019 ◽  
Vol 62 (3) ◽  
pp. 493
Author(s):  
Deepak Bansal ◽  
Renu Suthar ◽  
Deepti Suri ◽  
Prashant Sharma ◽  
Pallab Ray
Keyword(s):  
Bone Marrow ◽  
Unknown Origin ◽  
Pyrexia Of Unknown Origin ◽  
Bone Marrow Granuloma
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