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

A 7 week old baby presented with generalized lymphadenopathy, obstructive jaundice and massive hepatosplenomegaly. The clinical picture closely resembled a case of disseminated malignancy. Soon after the diagnosis of tuberculosis was made by pathological examination of a lymph node, the patient died. An autopsy revealed primary tuberculous foci in the liver and massive lymphadenopathy at the porta hepatis consistent with transplacentally acquired tuberculosis. The importance of early diagnosis and treatment of this rare condition is emphasized.
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PMID:Congenital tuberculosis. 261 41

Penicillium marneffei is a rare human pathogen that often causes problems in clinical and histological diagnosis. A patient who presented with autoimmune haemolytic anaemia and hepatosplenomegaly, and was subsequently found to be suffering from disseminated Penicillium marneffei infection, is reported. The liver biopsy showed epithelioid cell granulomas only, and tuberculosis was initially considered the most likely diagnosis. The correct diagnosis became evident in a subsequent colonic biopsy, which showed extensive infiltration by penicillium-laden macrophages.
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PMID:Penicillium marneffei infection: an underdiagnosed disease? 305 26

Forty-one black patients aged 21 to 75 years with hepatic tuberculosis diagnosed at liver biopsy were studied prospectively. The liver varied in size and consistency and was tender in 44 per cent of patients. Abdominal symptoms, weight loss, pyrexia, hepatomegaly, splenomegaly and anaemia were absent in 54, 39, 37, 5, 68 and 27 per cent of patients respectively. Twenty-two per cent of chest radiographs were normal. Liver function tests were of little diagnostic value and hepatic imaging techniques often gave normal results. Acid-fast bacilli, caseation and coexistent liver disease were detected in 59, 51 and 37 per cent of patients respectively. Since there was no consistent clinical pattern a high index of suspicion is necessary if this disease is to be detected in communities in which tuberculosis is endemic. In patients with unexplained hepatomegaly or hepatosplenomegaly or pyrexia of unknown origin liver biopsy provides the only means of making this diagnosis.
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PMID:A prospective study of hepatic tuberculosis in 41 black patients. 365 66

A case of fatal, generalized paracoccidioidomycosis is described in a four-year-old urban dwelling child. Marked lymphadenopathy, hepatosplenomegaly and an abdominal mass were the main clinical manifestations. The diagnosis was established by histopathological studies and culture. The authors comment on the rarity of this infection in children less than 7 years of age and on the importance of considering this pathology in the differential diagnosis of malignant non-Hodgkin lymphoma and tuberculosis, in children.
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PMID:Paracoccidioidomycosis in a four-year-old boy. 396 Jan 1

A survey of all patients in whom liver biopsy showed epithelioid granulomas was undertaken at two major teaching hospitals in Glasgow for the period 1970-1979. Seventy-seven patients with hepatic granulomas were studied retrospectively. In 53 cases (69 per cent) a clear-cut clinical diagnosis was established, which included sarcoidosis (eight cases), tuberculosis (eight), extrahepatic biliary obstruction (seven), primary liver diseases (11), neoplasm (six), bacterial infection (five) and miscellaneous (eight). In 24 patients (31 percent) no cause was found. Seventeen patients from this idiopathic group were studied prospectively and single examples of the following conditions were subsequently diagnosed; pulmonary tuberculosis, primary biliary cirrhosis, ulcerative colitis, adenocarcinoma of rectum, primary hepatocellular carcinoma, alpha-one antitrypsin deficiency and pulmonary fibrosis, sarcoidosis, pulmonary fibrosis alone, gallstones, rheumatic heart disease, unexplained hepatosplenomegaly and one death from mesenteric artery thrombosis. Only six cases remained truly idiopathic. Three of these patients recovered and in two liver biopsy became normal. The other three have persistent granulomas associated with continuing illness.
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PMID:Hepatic granulomas: experience over a 10-year period in the West of Scotland. 711 78

A patient is reported with disseminated tuberculosis presenting as massive hepatosplenomegaly and hepatic failure. The rare occurrence of huge enlargement of these organs in tuberculosis and the development of hepatocellular dysfunction progressing to hepatic coma is emphasized and pathogenesis discussed.
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PMID:Disseminated tuberculosis presenting as massive hepatosplenomegaly and hepatic failure. Case report. 730 51

The clinical characteristics of hepatic tuberculosis in 52 cases diagnosed pathologically were analyzed. Fever, abdominal pain and hepatomegaly were the major clinical manifestations; they were present in 96.2%, 42.3% and 88.5% of the patients respectively. The fever had no consistent pattern and the abdominal pain was usually localized to the right hypochondrium and not related to overwork. Hypergrammaglobulinaemia, elevated alkaline phosphatase level and increased ESR were noted in most of the patients (76.9%, 75.0%, 76.5% respectively). 62.5% of the 52 patients was diagnosed by percutaneous liver biopsy. Since there is no consistent clinical pattern in patients with hepatic tuberculosis, the diagnosis should be considered in patients with unexplained fever associated especially with hepatomegaly or hepatosplenomegaly, elevated alkaline phosphatase level, hypergrammaglobulinaemia and increased ESR, Liver biopsy is the most valuable method to confirm the diagnosis of hepatic tuberculosis.
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PMID:[Clinical characteristics of hepatic tuberculosis]. 760 Aug 75

During a 16-month period children presenting to a pediatric outpatient facility from an area with a high tuberculosis incidence (> 400/100,000) and suspected of having respiratory tuberculosis (TB) were evaluated for close contact with adult pulmonary tuberculosis, weight loss, symptom duration, respiratory signs, lymphadenopathy and hepatosplenomegaly and by chest radiography and tuberculin testing (Mantoux or tine). Probable tuberculosis was diagnosed in 258 children and was confirmed in 109 (42%) patients with a mean age of 31 months by culture of Mycobacterium tuberculosis from gastric aspirate or another source. Eleven children with confirmed TB had a normal chest radiograph. After review of special investigations, clinical course and follow-up of the remaining 149 children, 86 children (58%) with a mean age of 32.4 months were considered to have probable TB and 63 (42%) with a mean age of 27 months not to have TB. Significantly fewer children in the "not TB" group than in the confirmed and probable TB groups had a close adult pulmonary tuberculosis contact (13 (21%) and 95 (49%), respectively; P < 0.01). There was no difference between the "not TB" group and the confirmed and probable TB groups in the proportion presenting with weight loss, cough or other respiratory symptoms, a symptom duration > 2 weeks, the presence of bronchial breathing, wheeze, hepatomegaly or splenomegaly or peripheral lymphadenopathy. Final diagnoses in the "not TB" group included bacterial or viral pneumonia or bronchopneumonia in 37, asthma often accompanied by segmental collapse in 9 and cavitating pneumonia in 3 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Respiratory tuberculosis in childhood: the diagnostic value of clinical features and special investigations. 776 Nov 83

Five patients with proven intra-abdominal tuberculosis were examined with computed tomography (CT) over a period of one year. This revealed hepatosplenomegaly in all five cases. Macroscopic nodules were noted in the liver and spleen in three cases. All three cases showed more severe involvement of the spleen over the liver. Other features were enlarged (para-aortic, para-caval, peripancreatic and mesenteric) nodes, ascites, stellate mesentery and thickened bowel wall. Incidental extra-abdominal findings included intrathoracic nodules, pleural effusion, pericardial effusion with constrictive pericarditis, bony osteomyelitis and psoas abscess. Follow-up CT was performed on four of the five cases and showed significant resolution of the above findings. In addition, one case showed calcification within a healing splenic nodule. The presence of macroscopic nodules detected on CT, especially in the spleen, is an unusual finding in prior reports. This paper attempts to account for its high local incidence and discusses the significance of other findings in the diagnosis of abdominal tuberculosis.
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PMID:Computed tomographic findings of abdominal tuberculosis--report of five cases. 826 65

A 3-month-old infant with HIV-1 infection who recently immigrated from Ethiopia developed regional lymphadenitis and systemic symptoms subsequent to BCG immunization. She was suffering from axillary lymphadenitis ipsilateral to the BCG vaccination site, failure to thrive, unresolving fever and hepatosplenomegaly. Acid-fast bacilli were seen on staining and Mycobacterium bovis was isolated from the regional lymph node. The infant responded promptly to triple antituberculous therapy but died 2 months later from overwhelming pneumonia and respiratory failure. This case emphasizes the iatrogenic hazards of BCG immunization in HIV-1 infected infants. With the increasing prevalence of pediatric HIV-1 infection, indiscriminate BCG immunization programs should be reconsidered. While infants with asymptomatic HIV-1 infection at risk for tuberculosis should be immunized, BCG immunization should be withheld in those with symptomatic disease.
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PMID:Mycobacterium bovis lymphadenitis complicating BCG immunization in an infant with symptomatic HIV-1 infection. 834 56


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