title: Peripheral blood and marrow findings in disseminated bacille Calmette-Guerin infection.
abstract: The authors describe an unusual case of a disseminated bacille Calmette-Guerin (BCG) infection in a 3-month-old girl who presented with a huge hepatosplenomegaly, fever, and pancytopenia. Clinically, an infantile kala-azar or lymphoma/leukemia was suspected. However, after thorough clinical and paraclinical investigations, the case was diagnosed as a disseminated BCG infection. The child died 2 weeks after starting antituberculosis treatment. Autopsy revealed diffuse histiocytic infiltration in the liver, spleen, and mesenteric lymph nodes, which were loaded with acid-fast bacilli. Three interesting findings were noticed in this case: circulating monocytes in the peripheral blood were loaded with ghost acid-fast bacilli; bone marrow smears revealed numerous Gaucher cell-like macrophages loaded with negative images of Mycobacterium tuberculi; and there was extensive marrow necrosis. These findings have not been previously reported in the literature.
authors.affiliation: Department of Pathology, Shiraz Medical School, Shiraz, Iran. kumarv@sums.ac.ir
authors.forename: Perikala Vijayananda
authors.initials: PV
authors.lastname: Kumar
authors.forename: Ahmad
authors.initials: A
authors.lastname: Monabati
authors.forename: Rahim
authors.initials: R
authors.lastname: Kadivar
authors.forename: Hossein
authors.initials: H
authors.lastname: Soleimanpour
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000209:etiology; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D007223:Infant; D009163:Mycobacterium bovis / Q000472:pathogenicity*; D009336:Necrosis; D010198:Pancytopenia / Q000209:etiology; D013163:Splenomegaly / Q000209:etiology; D014376:Tuberculosis / Q000150:complications* / Q000382:microbiology / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents