title: Hepatosplenic tuberculosis: a cause of persistent fever during recovery from prolonged neutropenia.
abstract: METHODS
  Hepatosplenic abscesses in neutropenic patients, especially during the recovery phase, are almost always attributed to fungal infections. We report similar lesions due to Mycobacterium tuberculosis in neutropenic patients in a tertiary care centre in India.
  
  
  OBJECTIVE
  To characterize the features of hepatosplenic tuberculosis in neutropenic patients.
  
  
  METHODS
  Retrospective comparison of disease pattern and response to treatment of hepatosplenic tuberculosis in febrile neutropenia patients (four of 30 with severe prolonged neutropenia) and in non neutropenic patients diagnosed during the same 12-month period (n = 4, control group).
  
  
  RESULTS
  The disease in the neutropenic patients typically presented during the recovery phase of neutropenia, with ultrasonic abnormalities similar to those seen in hepatosplenic fungal infections. In contrast to the marked organomegaly and typical granulomatous response found in the control group, the disease in the neutropenic patients was characterised by an absence of organomegaly, non-involvement of other sites, poor inflammatory response and a high bacillary load. The initial response to therapy was satisfactory in both groups.
  
  
  CONCLUSIONS
  Tuberculosis needs to be considered in the diagnostic work-up of hepatosplenic abscesses that occur during the recovery phase of neutropenia.
authors.affiliation: Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Chakrabarti
authors.forename: S
authors.initials: S
authors.lastname: Varma
authors.forename: R
authors.initials: R
authors.lastname: Kochhar
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: S K
authors.initials: SK
authors.lastname: Gupta
authors.forename: A
authors.initials: A
authors.lastname: Rajwanshi
mesh_terms: D000038:Abscess / Q000150:complications; D000328:Adult; D000368:Aged; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000150:complications; D014400:Tuberculosis, Splenic / Q000175:diagnosis*