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Query: UMLS:C0019214 (hepatosplenomegaly)
 4,408 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hepatic fibrin-ring granulomas and leishmania parasites were found in the liver biopsy specimens of 3 patients with prolonged fever and hepatosplenomegaly. It was recognition of the leishmanias in the liver biopsy specimen that prompted the diagnosis in all cases. There was no evidence of Q fever, Hodgkin's disease, cytomegalovirus hepatitis, or allopurinol treatment, which are the recognized causes of hepatic fibrin-ring granulomas. This report extends the range of etiologies of hepatic fibrin-ring granulomas. As a result, leishmaniasis should always be a consideration to the pathologist and the clinician in the differential diagnosis of fibrin-ring granulomas.
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PMID:Hepatic fibrin-ring granulomas in visceral leishmaniasis. 341 Feb 27

Two children with congenital heart disease developed persistent fever, anemia, and hepatosplenomegaly. Both were shown to have intracardiac vegetations and evidence of infection with Coxiella burnetti. Thus, the same clinical manifestations of Q fever may develop in both children and adults.
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PMID:Chronic Q fever endocarditis with massive splenomegaly in childhood. 395 26

A 51-year-old woman, originating from Algeria, developed Q fever endocarditis on porcine bioprosthetic mitral valve. She had chronic course with nonspecific symptoms, such as dyspnea and fever, hepatosplenomegaly, and developed progressive cardiac failure. Worsening of hemodynamic state led to prosthetic valve replacement. Hemocultures were all negative, and the diagnosis of Q fever was unexpectedly performed by systematic screening for specific serum antibody to Coxiella burnetti. High phase I and II specific IgG and IgA antibody titers against C burnetii were found. The patient was treated by doxycycline and ofloxacin, and improved rapidly. Prosthetic valve constitutes likely predisposing factor for the development of chronic Q fever endocarditis. This observation emphasizes the need to search for Q fever in prosthetic valve dysfunction, in particular when hemocultures are negative.
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PMID:[Coxiella burnetii endocarditis on a bioprosthetic valve: review of the literature apropos of a case]. 819 Nov 3

In Nova Scotia the main manifestation of acute Q fever is pneumonia, while in France it is granulomatous hepatitis. To test the hypothesis that the route of infection is the major determinant of the manifestations of acute Q fever, 10 groups of 10- to 12-g female BALB/c mice (4 animals/group) were used. Five groups were inoculated intraperitoneally (ip) and 5 intranasally (inl) with Coxiella burnetii. Both routes of infection resulted in pneumonia. However, the inl route resulted in greater airway changes (on a numeric scale with 0 being no changes): 2.05 +/- 2.20 versus 0.60 +/- 0.83 (P < .002). The ip route resulted only in hepatosplenomegaly. It was concluded that the route of infection is one determinant of the manifestations of acute Q fever.
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PMID:Route of infection determines the clinical manifestations of acute Q fever. 856 18

Scrub typhus is widespread in rural south and southeastern Asia and the western Pacific. The scrub typhus incidence is the highest among vector-borne diseases in Japan, but imported cases are extremely rare. A 49-year-old man admitted for persistent fever, headache, and rash after returning from Myanmar had been exposed to mosquito and tick bites while doing a 12-day forest inventory in Myanmar. On admission, he had a generalized maculopapular rash but no apparent eschars characteristic of scrub typhus. Blood examination and abdominal ultrasonography showed elevated liver enzymes, thrombocytopenia, and hepatosplenomegaly. Repeated blood smears and blood cultures were negative for malaria infection and bacteremia. Dengue fever was denied by both PCR and serology. The patient deteriorated on the ninth day and suffered complications of rhabdomyolysis, pneumonia, and enteritis. Based on a tentative diagnosis of typhoid fever or rickettiosis, we administratered ceftriaxone and minocycline, which dramatically reduced clinical signs and symptoms. After discharge on day 19, immunofluorescence assay showed significantly increased antibodies for Orienta tsutsugamushi serotype Gilliam, first discovered in Myanmar. All serological results were negative for other rickettioses, leptospirosis and Q fever. Given the many travelers from Japan visiting endemic scrub typhus areas, we must recognize cases of imported scrub typhus among those travelers with fever and rash returning from endemic areas.
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PMID:[Case of imported scrub typhus contracted in Myanmar]. 1952 10

Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of excessive inflammation and tissue destruction due to abnormal immune activation and inflammation. HLH can occur primarily due to genetic etiology, or secondarily associated with malignancies, autoimmmune diseases or infections. There are a number of reports that revealed the relationship of hemophagocytosis with brucellosis. In this report, we described a brucellosis-related HLH case. A 73-year-old male who work as farmer was admitted to our hospital with the complaints of fever continuing for 10 days, loss of appetite and back pain. Physical examination revealed right upper quadrant tenderness and hepatomegaly. Since the patient exhibited five of the diagnostic criteria for HLH (fever, hepatosplenomegaly, bicytopenia, hypertriglyceridemia and high ferritin level), he was diagnosed as secondary HLH. PCR, microscopic agglutination and indirect fluorescent antibody tests gave negative results for the diagnosis of Crimean-Congo hemorrhagic fever, leptospirosis and Q fever, respectively. On the other hand, Rose Bengal test for brucellosis was positive, while standard tube agglutination test (STA) was negative. The patient's serum yielded a very high positive (1/1280) result when Coombs' test was performed in terms of the possibility of blocking antibodies or prozone phenomenon. Additionally, B.melitensis was isolated from his blood culture on the sixth day. The patient was treated with doxycycline and rifampicin, and on the 10th day of antibiotic therapy the patient was discharged and recommended to complete his treatment up to 6 weeks. In conclusion, in patients with secondary HLH symptoms especially in the endemic areas, brucellosis should be considered as a predisposing infection.
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PMID:[Brucellosis as a cause of hemophagocytic syndrome]. 2616 30

Hemophagocytic Lymphohistiocytosis (HLH) is a reactive disorder of the mononuclear phagocytic system characterized by increased histiocytic proliferation, activation and hemaphagocytosis. The underlying etiology may be genetic (primary) or acquired (secondary). Secondary causes include drugs, autoimmune diseases, malignancies and infections of which EBV is the most common. A 28-year old male patient who was a shepherd with no known concomitant comorbid disease was admitted to the Emergency Department with the complaints of abdominal pain, fever, severe fatigue. Physical examination revealed high fever, hepatosplenomegaly and laboratory examination revealed pancytopenia, hyperferritinemia and hypertriglyceridemia. Hemophagocytes were observed in the bone marrow biopsy and the patient was diagnosed as HLH. The patient was treated with cyclosporine A, dexamethasone, intravenous immunoglobulin (IvIg) and etoposide according to the HLH 2004 protocol. Coxiella burnetii was detected in the serological evaluation of the etiology and doxycycline was added to the current treatment. Fever was controlled in the second week of the treatment and the patient was discharged after complete recovery of the cytopenia in the fourth week. In the outpatient setting, treatment was completed in 8 weeks and follow-up of the patient is still ongoing without medication. To the best of our knowledge, this is the first case from Turkey of HLH secondary to Q-fever which was treated and managed successfully. Since the mortality of HLH is quite high, the etiology should be determined as soon as possible to be able to provide appropriate treatment.
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PMID:Q fever as a rare cause of hemophagocytic lymphohistiocytosis: Case report. 3217 85