scholarly journals Rare splenic complications and specific serology: decisive diagnostic tools in two cases of visceral leishmaniasis

2012 ◽  
pp. 274-277
Author(s):  
Andrea Celestini ◽  
Federica Paglia ◽  
Orlando Dell’ Unto ◽  
Riccardo Guarisco ◽  
Claudio Puoti
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy ◽  
Clinical Presentation ◽  
Splenic Rupture ◽  
Splenic Infarction ◽  
Diagnostic Tools ◽  
Minor Trauma ◽  
Vector Borne ◽  
A Minor

Introduction: Visceral leishmaniasis (VL) is a major endemic vector-borne disease in Southern Europe. We present two cases of VL, both characterized by splenic complications. Methods and results: Case 1: A 47-year-old female presented with effort angina, hepatosplenomegaly and pancytopenia. The clinical course was complicated by splenic infarction. Although bone marrow biopsy failed to show amastigotes, diagnosis was performed by a fast agglutinating screening test (FAST) and confirmed by a direct agglutinating test (DAT). The patient was treated successfully with AmBisome. Case 2: A 22-year-old male who had undergone a splenectomy to treat splenic rupture related to a minor trauma four months earlier presented with fever, nocturnal sweats and weight loss. The lack of pancytopenia was due to the absence of the spleen. The first biopsy did not identify parasites, but because the FAST had been positive, another bone marrow biopsy was performed, which demonstrated leishmaniasis. This patient was treated with the same schedule of AmBisome infusion. Discussion: 1) The clinical presentation of VL can be atypical, 2) splenic complications can characterize this disease, and 3) specific serology may be an important tool to reach a diagnosis.

scholarly journals Role of the Bone Marrow Examination among Undifferentiated Fever in Tropics

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy ◽  
Clinical Decision Making ◽  
Bone Marrow Aspiration ◽  
Clinical Decision ◽  
Bone Marrow Examination ◽  
Diagnostic Tools ◽  
P Value ◽  
Highly Sensitive

Background: Bone marrow aspiration and biopsy is one of the most important diagnostic tools for evaluation of undifferentiated fever. The positivity yield of these samples is highly specific that provides additional evidence for clinical decision making among the undifferentiated febrile cases. With this background we evaluated the bone marrow results of undifferentiated febrile cases for the last five years at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. The objective of the study was to measure the sensitivity of the bone marrow investigations among undifferentiated febrile cohort. Methods: A retrospective study was performed from January 2010 till December 2014 evaluating bone marrow reports. Completed request forms and the histopathological reports of the bone marrow specimens were reviewed. Statistical data was analyzed using SPSS 17 and p-value of <0.05 was considered significant. Results: Over the half decade 319 specimens were collected for bone marrow biopsy out of that 27% were requested for undifferentiated fever. The mean and median age of the biopsy performed patients was 35 and 31 years respectively. Among all biopsy samples 59% was adequate for evaluation however among the undifferentiated febrile cases biopsy samples only 45% was adequate for evaluation. The sensitivity of bone marrow biopsy was 34%. There were 714 bone marrow aspiration samples of that 84% was adequate for evaluation. The most common etiological diagnosis for the undifferentiated fever from the marrow evaluation was visceral leishmaniasis (53%). The sensitivity of the bone marrow aspiration and aspiration or biopsy for visceral leishmaniasis was 95% and 98% respectively. (p value 0.03) Conclusion: Bone marrow aspiration is highly sensitive and specific for the diagnosis of visceral leishmaniasis among the undifferentiated fever at tropics in Nepal.

scholarly journals Clinical and laboratory profiles of visceral leishmaniasis among adult patients admitted to Felege Hiwot Hospital, Bahir Dar, Ethiopia

2021 ◽  
Vol 9 ◽  
pp. 205031212110367
Author(s):  
Berhanu Tarekegn ◽  
Ayanaw Tamene
Keyword(s):  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Clinical Presentation ◽  
Winter Season ◽  
Adult Patients ◽  
Sand Fly ◽  
Timely Initiation ◽  
Vector Borne Disease ◽  
Vector Borne ◽  
Endemic Areas

Background: Visceral leishmaniasis is a vector-borne disease caused by Leishmania donovani transmitted by sand fly species. It is the third most common vector-borne disease globally. Visceral leishmaniasis is endemic in Ethiopia with an estimated annual incidence ranging from 3700 to 7400 cases. This research aimed to assess the clinical presentations and laboratory profiles of visceral leishmaniasis for early diagnosis and timely initiation of management. Objective: To describe the clinical and laboratory manifestation and diagnostic modalities of visceral leishmaniasis among adult patients admitted to Felege Hiwot Hospital, from 1 September 2016 to 30 August 2019. Method: Institution-based retrospective cross-sectional study was conducted among 141 patients admitted to Felege Hiwot Hospital from 1 September 2016 to 30 August 2019. Descriptive statistics were used to describe the clinical presentation and laboratory profiles of patients with visceral leishmaniasis. Results: Among a total of 141 enrolled patients in the study, males were affected 13-fold. Most of them were travelers to endemic areas during the winter season for labor work. The mean duration of illness was 48 days. Common symptoms were fever (96.5%), weightless (82.5%), jaundice (18.4%), vomiting/diarrhea (13.5%), and bleeding episodes (11.3%). Splenomegaly was seen in 98.6%, ascites in 35.5%, and lymphadenopathy in 9.9%. Lymphadenopathy was seen significantly in HIV patients (40%). Anemia was seen in 95%, thrombocytopenia in 90.2%, leukopenia in 86.4%, and pancytopenia in 79.4%. Half of the patients had coinfection. Neutropenic sepsis was seen in 21.3%. The diagnosis was made by tissue aspiration in 65% of patients. Conclusion: The majority of patients who were diagnosed to have visceral leishmaniasis were young male adults who traveled to the endemic areas seasonally. Fever and splenomegaly were seen as the commonest clinical presentation. Lymphadenopathy occurred in high frequency among HIV co-infected patients. Anemia was the commonest hematologic finding.

Visceral Leishmaniasis: Bone Marrow Biopsy Findings

2007 ◽  
Vol 29 (2) ◽  
pp. 77-80 ◽  
Author(s):  
Perikala Vijayananda Kumar ◽  
Mohammad Vasei ◽  
Alireza Sadeghipour ◽  
Esmaeel Sadeghi ◽  
Hossein Soleimanpour ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy

Osteoporosis as clinical presentation of systemic mastocytosis: Diagnostic value of bone marrow biopsy

1992 ◽  
Vol 17 ◽  
pp. 148
Author(s):  
P. Ballanti ◽  
P. Bianco ◽  
R.Franchi De Luca ◽  
G. Silvestrini ◽  
E. Bonucci
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Clinical Presentation ◽  
Systemic Mastocytosis ◽  
Diagnostic Value

scholarly journals Excessive Tongue Amyloidosis as the Diagnostic Sign of Multiple Myeloma: a Case Report

2015 ◽  
Vol 19 (1) ◽  
pp. 50-52
Author(s):  
Stylianos Dalampiras ◽  
Dimitrios Andreadis ◽  
Ioannis Kostopoulos ◽  
Florentia Stylianou ◽  
Ioannis Papadiochos ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Case Report ◽  
Laboratory Investigation ◽  
Bone Marrow Biopsy ◽  
Clinical Presentation ◽  
Systemic Disease ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Initial Sign

SUMMARYBackground: Deposition of amyloid in oral mucosa may be related to systemic disorders, including immune-related diseases and malignancies.Clinical Presentation: We describe a case of 76-year-old patient with excessive, painless, multi-nodular tongue enlargement, and petechiae on the vermilion border and perioral skin that appeared 2 months ago. The biopsy detected subepithelial, Congo’s Red positive amyloid depositions. Consequent laboratory investigation and bone marrow biopsy confirmed the diagnosis of multiple myeloma stage 2 (International Prognostic Index - IPI).Conclusion: Multi-nodular excessive tongue enlargement could be of high significance as initial sign of undiagnosed, underlying systemic disease including severe malignancy like multiple myeloma.

scholarly journals Visceral Leishmaniasis in a UK Toddler following a Short Trip to a Popular Holiday Destination in Spain

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Neda Minakaran ◽  
Talha Soorma ◽  
Shamez N. Ladhani
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Klebsiella Pneumoniae ◽  
Bone Marrow Biopsy ◽  
Haematological Malignancy ◽  
Short Trip ◽  
Initial Symptoms ◽  
The Uk

We herein present the case of a 15-month-old with visceral leishmaniasis diagnosed in the UK following a short trip to a popular holiday destination in Spain. Four months after the initial symptoms, the diagnosis was made incidentally on microscopy of a bone marrow biopsy taken for suspected haematological malignancy after the child developed hepatosplenomegaly, pancytopaenia, andKlebsiella pneumoniaesepticaemia.

scholarly journals Atypical pyoderma gangrenosum in a patient with osteomyelofibrosis

2007 ◽  
Vol 64 (11) ◽  
pp. 787-789 ◽  
Author(s):  
Dubravka Zivanovic ◽  
Srdjan Tanasilovic ◽  
Dusan Skiljevic ◽  
Maja Tomovic ◽  
Andrija Bogdanovic ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Clinical Presentation ◽  
Myeloproliferative Disorders ◽  
Upper Extremities ◽  
Minor Trauma ◽  
Systemic Steroids ◽  
Dorsal Aspect ◽  
Skin Malignancy ◽  
Underlying Malignancy ◽  
A Minor

Background. Atypical forms of pyoderma gangrenosum generally appear on the upper extremities; most frequently they are associated with myeloproliferative disorders, including osteomyelofibrosis. A response to systemic steroids is more pronounced than in classical form. Sometimes it may be the first sign of an underlying malignancy. Case report. We reported a patient with atypical pyoderma gangrenosum developed during the course of a myeloid malignancy - osteomyelofibrosis. The lesions occurred after a minor trauma. Painful blistering plaques, with an elevated, bluish-gray border were located on the dorsal aspect of hands. No skin malignancy was found. The lesions resolved rapidly to systemic steroids. Conclusion. Considering the unusual clinical presentation which makes the diagnosis difficult, as well as the fact that atypical forms of pyoderma gangrenosum can be the first sign of malignancies, especially myeloproliferative ones, recognizing this entity enables timely guiding future investigations toward their prompt detection.

scholarly journals Neurological involvement in visceral leishmaniasis: case report

2010 ◽  
Vol 43 (6) ◽  
pp. 743-745 ◽  
Author(s):  
Lílian Martins Oliveira Diniz ◽  
Helena Duani ◽  
Camila Rodrigues Freitas ◽  
Rosângela Maria Figueiredo ◽  
Christovão Castro Xavier
Keyword(s):  
Bone Marrow ◽  
Weight Loss ◽  
Visceral Leishmaniasis ◽  
Bacterial Infections ◽  
Specific Treatment ◽  
Neurological Involvement ◽  
Neurological Signs ◽  
Parasite Detection ◽  
Visceral Leishmaniasis Case ◽  
Vector Borne

Visceral leishmaniasis is a severe and potentially fatal vector-borne disease. The most typical symptoms are fever, hepatosplenomegaly, weight loss, bleeding and bacterial infections. Neurological changes are rarely reported. This paper describes a child who presented with neurological signs as the first symptoms of leishmaniasis; tone was diminished and tremors in the extremities were observed. A diagnosis of visceral leishmaniasis was confirmed by parasite detection in the bone marrow. Symptoms were reversed by specific treatment. The nature of a possible mechanism of neurological involvement in visceral leishmaniasis remains unexplained.

scholarly journals Case Report: Visceral Leishmaniasis and Hemophagocytic Lymphohistiocytosis: Three Clinical Cases, Three Different Pattern

2021 ◽  
Author(s):  
Geydson Silveira Cruz ◽  
Amélia Ribeiro de Jesus ◽  
Roque Pacheco Almeida ◽  
Maria Aurélia Porto
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Presentation ◽  
Rare Condition ◽  
Neglected Tropical Disease ◽  
Parasitic Diseases ◽  
Risk Of Death ◽  
Delayed Recognition ◽  
Secondary Causes

Visceral leishmaniasis (VL) is a neglected tropical disease with more than 30,000 cases annually reported worldwide. In Brazil, about 3,700 cases are annually reported. The VL clinical presentation is variable, from asymptomatic to severe cases with a high risk of death. We reported three cases of VL with clinical sign similarities but distinct development. All cases had bone marrow hemophagocytosis and hemophagocytic lymphohistiocytosis (HLH) criteria. HLH is a rare condition that may have secondary causes, including infectious and parasitic diseases, like VL. The delayed recognition of the secondary HLH (sHLH) association to VL may cause unfavorable outcomes and death.

scholarly journals Vertebral Compression Fractures—The First Manifestations in the Elderly Acute Lymphoblastic Leukemia

2021 ◽  
Vol 12 ◽  
pp. 215145932110268
Author(s):  
Cheng Liu ◽  
Cuili Shu
Keyword(s):  
Bone Marrow ◽  
Acute Lymphoblastic Leukemia ◽  
Bone Marrow Biopsy ◽  
Lymphoblastic Leukemia ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Minor Trauma ◽  
Initial Manifestation ◽  
Normal Peripheral Blood ◽  
Compression Fractures

Background: Acute lymphoblastic leukemia (ALL) is reported to be the most common malignancy in children, but is less common in adults. Though vertebral compression fractures have been reported as initial signs of ALL in children, to the best of our knowledge, there have not been any previous reports of vertebral compression fractures as an initial manifestation of ALL in elderly people. Case Presentation: Here we reported a 65-year-old man who was admitted with a 1-month history of progressive chest and back pain and worsening pain after heavy lifting. Considering the histories of osteoporosis, minor trauma and normal peripheral blood counts, it was firstly misdiagnosed as spinal osteoporotic compression fractures which were caused by low-energy injuries. The patient was definitely diagnosed as ALL after bone marrow biopsy. Conclusion: ALL must be considered in the differential diagnosis with acute vertebral compression fracture. Considering that bony lesions may precede clinical findings, knowledge of radiographic and orthopedic appearances of leukemia are important in order to initiate earlier treatment to avoid the progressive damage and improve their survival rates. we recommend bone marrow biopsy in vertebroplasty to avoid misdiagnosis.

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