Disseminated tuberculosis presenting with secondary haemophagocytic lymphohistiocytosis and Poncet’s disease in an immunocompetent individual

Kushal, Naha and Dasari, Sowjanya and Vivek, G and Prabhu, Mukhyaprana (2013) Disseminated tuberculosis presenting with secondary haemophagocytic lymphohistiocytosis and Poncet’s disease in an immunocompetent individual. BMJ Case Reports. pp. 1-4.

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Abstract

We report a 27-year-old previously healthy man, who presented with fever and painful swelling of both ankles for 6 months, and who had been jaundiced for 1 week. Clinical examination revealed diffuse macular rash, severe pallor, deep icterus, generalised lymphadenopathy and hepatosplenomegaly. Detailed evaluation revealed granulomata in bone marrow aspirate, and numerous acid fast bacilli in lymph node biopsy. Bone marrow PCR was also positive for Mycobacterium tuberculosis . A diagnosis of disseminated tuberculosis was made and antitubercular therapy was initiated. Investigation also showed features of haemophagocytosis within the bone marrow. Results of further tests satis fied the criteria for haemophagocytic lymphohistiocytosis, probably secondary to tuberculosis. However, rapid deterioration in his clinical condition led to his death within 5 days of diagnosis, before appropriate therapy for haemophagocytic lymphohistiocytosis could be instituted. This case report highlights an unusual and deadly presentation of tuberculosis in an immunocompetent individual

Item Type: Article
Subjects: Medicine > KMC Manipal > Cardiology
Medicine > KMC Manipal > Medicine
Depositing User: KMC Manipal
Date Deposited: 09 Apr 2013 10:34
Last Modified: 09 Apr 2013 10:34
URI: http://eprints.manipal.edu/id/eprint/79582

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