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[Pancytopenia, hepatosplenomegaly and dry cough after breast cancer].
Dtsch Med Wochenschr. 2009 Jun; 134(24):1269-73.DM

Abstract

HISTORY AND CLINICAL FINDINGS

A 71-year-old woman had suffered for 6 weeks from fatigue, dry cough and fever. Five years previously breast cancer had been diagnosed and had been successfully treated with subtotal mastectomy and postoperative radiotherapy, as well as aromatase inhibitor until shortly before the present admission. There was no history of travel to tropical countries, but during the last summer she had spent two weeks in Northern Italy. [corrected]

INVESTIGATIONS

On admission the body temperature was 38,5 C with a mild tachycardia (108/min). Laboratory findings revealed a pancytopenia and slightly elevated liver enzymes. The ultrasound showed a hepatosplenomegaly. The investigation of the bone marrow showed a great amount of parasitic forms due to visceral leishmaniasis [corrected] TREATMENT, COURSE AND DIAGNOSIS: Treatment with liposomal amphotericin B brought about rapid improvement, the dry cough subsided and the laboratory results became normal.

CONCLUSION

Pancytopenia, fever, dry cough and hepatosplenomegaly after travelling to Mediterranean countries should raise suspicion of visceral leishmaniasis. This diagnosis is confirmed by direct detection of the parasite in the bone marrow. Administration of liposomal amphotericin B is efficacious and safe, bringing about full recovery in up to 90% of cases.

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Authors+Show Affiliations

Seilmaier M
Medizinische Klinik, Klinik für Hämatologie, Onkologie, Immunologie, Palliativmedizin, Infektiologie, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität München, München. drmseil@gmx.net
Hecht A
No affiliation info available
Guggemos W
No affiliation info available
Adorf D
No affiliation info available
Gehbauer G
No affiliation info available

MeSH

AgedAmphotericin BAntiprotozoal AgentsAromatase InhibitorsBreast NeoplasmsChemotherapy, AdjuvantCoughDiagnosis, DifferentialFatigueFemaleFeverHepatomegalyHumansItalyLeishmaniasis, VisceralLiposomesMastectomy, SegmentalPancytopeniaPrognosisRadiotherapy, AdjuvantSplenomegalyTachycardiaTravel

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

ger

PubMed ID

19499497

Citation

Seilmaier, M, et al. "[Pancytopenia, Hepatosplenomegaly and Dry Cough After Breast Cancer]." Deutsche Medizinische Wochenschrift (1946), vol. 134, no. 24, 2009, pp. 1269-73.
Seilmaier M, Hecht A, Guggemos W, et al. [Pancytopenia, hepatosplenomegaly and dry cough after breast cancer]. Dtsch Med Wochenschr. 2009;134(24):1269-73.
Seilmaier, M., Hecht, A., Guggemos, W., Adorf, D., & Gehbauer, G. (2009). [Pancytopenia, hepatosplenomegaly and dry cough after breast cancer]. Deutsche Medizinische Wochenschrift (1946), 134(24), 1269-73. https://doi.org/10.1055/s-0029-1225274
Seilmaier M, et al. [Pancytopenia, Hepatosplenomegaly and Dry Cough After Breast Cancer]. Dtsch Med Wochenschr. 2009;134(24):1269-73. PubMed PMID: 19499497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Pancytopenia, hepatosplenomegaly and dry cough after breast cancer]. AU - Seilmaier,M, AU - Hecht,A, AU - Guggemos,W, AU - Adorf,D, AU - Gehbauer,G, Y1 - 2009/06/04/ PY - 2009/6/6/entrez PY - 2009/6/6/pubmed PY - 2009/6/12/medline SP - 1269 EP - 73 JF - Deutsche medizinische Wochenschrift (1946) JO - Dtsch Med Wochenschr VL - 134 IS - 24 N2 - HISTORY AND CLINICAL FINDINGS: A 71-year-old woman had suffered for 6 weeks from fatigue, dry cough and fever. Five years previously breast cancer had been diagnosed and had been successfully treated with subtotal mastectomy and postoperative radiotherapy, as well as aromatase inhibitor until shortly before the present admission. There was no history of travel to tropical countries, but during the last summer she had spent two weeks in Northern Italy. [corrected] INVESTIGATIONS: On admission the body temperature was 38,5 C with a mild tachycardia (108/min). Laboratory findings revealed a pancytopenia and slightly elevated liver enzymes. The ultrasound showed a hepatosplenomegaly. The investigation of the bone marrow showed a great amount of parasitic forms due to visceral leishmaniasis [corrected] TREATMENT, COURSE AND DIAGNOSIS: Treatment with liposomal amphotericin B brought about rapid improvement, the dry cough subsided and the laboratory results became normal. CONCLUSION: Pancytopenia, fever, dry cough and hepatosplenomegaly after travelling to Mediterranean countries should raise suspicion of visceral leishmaniasis. This diagnosis is confirmed by direct detection of the parasite in the bone marrow. Administration of liposomal amphotericin B is efficacious and safe, bringing about full recovery in up to 90% of cases. SN - 1439-4413 UR - https://www.unboundmedicine.com/medline/citation/19499497/[Pancytopenia_hepatosplenomegaly_and_dry_cough_after_breast_cancer]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1225274 DB - PRIME DP - Unbound Medicine ER -