Kumar Rajesh, Sharma Prashant, Dey Pranab, Thapa Babu Ram
Pathology Group of Departments, Levels 4-5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India.
Department of Hematology, Level 5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India.
Indian J Hematol Blood Transfus. 2017 Mar;33(1):130-132. doi: 10.1007/s12288-016-0710-y. Epub 2016 Aug 3.
A 6-year-old boy presented with a 3-month history of high-grade fever and night-sweats but without chills/rigors. On examination, he had moderate hepatosplenomegaly with multiple enlarged cervical and axillary lymph nodes. His hemogram revealed anemia and marked eosinophilia. Initial investigations were negative, except anti-HCV IgG antibodies, that were positive. Bone marrow aspirate showed a single histiocyte containing suspicious intracellular yeast-like forms. Cervical lymph node aspiration revealed a heavy load of intra- and extra-cellular spp. Disseminated histoplasmosis remains an unusual cause of peripheral eosinophilia and diagnosis can often be rendered fairly easily by cytomorphological evaluation. The case illustrates how Indian pathologists must maintain a high index of suspicion for unexpected infectious disorders in cases with eosinophilia.
一名6岁男孩有3个月的高热和盗汗病史，但无寒战/畏寒。检查发现他有中度肝脾肿大，伴有多处颈部和腋窝淋巴结肿大。他的血常规显示贫血和明显的嗜酸性粒细胞增多。除抗丙型肝炎病毒IgG抗体呈阳性外，初步检查均为阴性。骨髓穿刺显示单个组织细胞含有可疑的细胞内酵母样形态。颈部淋巴结穿刺显示细胞内和细胞外有大量 菌。播散性组织胞浆菌病仍然是外周嗜酸性粒细胞增多的罕见原因，通过细胞形态学评估通常可以很容易地做出诊断。该病例说明了印度病理学家在嗜酸性粒细胞增多的病例中对意外感染性疾病必须保持高度怀疑。
