PROLONGED FEVER AND ULTRASOUND, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

MAN 36 YO FEVER FOR  40 DAYS # 39 Celsus DEGREE AND SORE THROAT
NO RESPONSE WITH ANTIBIOTIC TREATMENT.

FIRST ULTRASOUND OF THE ABDOMEN DETECTED BIG LIVER AND SPLEEN, SUSGESTED MALARIA. BUT BLOOD TEST  RULES OUT.

MSCT ABDOMEN, SUSGESTED BIG SPLEEN LIKE INFECTED SPLEEN OR LYMPHOMA.

THE SECOND ULTRASOUND DETECTED MANY LYMPH NODES AT THE NECK , SIZE
1-3 CM, ECHO POOR, NO MORE VASCULATURE.

BIOPSY THIS LYMPH NODE FOR MAKING SURE THE DIAGNOSIS.

Waiting long time for immuno-histo staining the lymph node biopsy, the result is look like true-lymphoma, but the bone marrow biopsy show that it is HLH (hemophagocytic-lymphohistiocytic) and blood test also EBV positive.

Summary:
This prolonged fever case with sore throat, cervical lymphoadenopathy, blood test is leukopenia, with EBV Elisa test positve. Ultrasound and CT say HEPATO-SPLENOMEGALIA. BONE MARROW biopsy confirmed that HLH.

THE DIAGNOSIS IS MADE AFTER 50 DAYS FEVER.