Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia

An 18-year-old male was admitted for his second induction chemotherapy treatment for an acute lymphoblastic leukemia with cyclophosphamide, cytarabine, and mercaptopurine. Later, he presented with high fever, abdominal pain, non-bloody diarrhea, portal hypertension and leukopenia. Stool sample analy...

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Detalles Bibliográficos
Autores principales: Santarelli, Ignacio Martín, Manzella, Pedro Oscar, Ingold, Julián José, Legnoverde, Sofía, Falcón, María Florencia, Fernández, Sofía Isabel, Melero, Marcelo José
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Universidad Nacional de Córdoba 2022
Materias:
Problemas Diagnósticos
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9590815/
https://www.ncbi.nlm.nih.gov/pubmed/36149078
http://dx.doi.org/10.31053/1853.0605.v79.n3.34402
Descripción
Sumario:An 18-year-old male was admitted for his second induction chemotherapy treatment for an acute lymphoblastic leukemia with cyclophosphamide, cytarabine, and mercaptopurine. Later, he presented with high fever, abdominal pain, non-bloody diarrhea, portal hypertension and leukopenia. Stool sample analysis, blood cultures and extensive work-up were negative. The only microbiologic evidence was the presence of cytomegalovirus DNA detected by PCR. A profound hypogammaglobulinemia was documented. Pathology material reported non-caseating granulomas in liver, bone marrow, duodenum and colon with negative cytomegalovirus immunostaining. What is your diagnosis?

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