title: Clinical characteristics and the usefulness of the QuantiFERON-TB Gold In-Tube test in hematologic patients with hepatic or splenic lesions.
abstract: OBJECTIVE
  Hepatic or splenic lesions in hematologic patients are not defined well because they are not easy to evaluate due to limitations of invasive procedures. Management typically depends on the clinical diagnosis with few microbiological data.
  
  
  METHODS
  We reviewed the medical records of consecutive hematologic patients with hepatic or splenic lesions in the infectious diseases unit from April 2009 to December 2010 at the Catholic Hematopoietic Stem Cell Transplantation Center in Korea.
  
  
  RESULTS
  Twenty-six patients were identified. Their mean age was 46.0 ± 14.7 years, and 16 (61.5%) were male. Underlying diseases were acute myelogenous leukemia (n = 15, 57.7%) and myelodysplastic syndrome (n = 6, 23.1%). Among the nine nontuberculous infectious lesions, two bacterial, six fungal, and one combined infection were identified. The numbers of confirmed, probable, and possible tuberculosis (TB) cases were one, three, and four, respectively. Two patients had concurrent pulmonary TB. QuantiFERON-TB Gold In-Tube (QFT-GIT, Cellestis Ltd.) was positive in seven cases, among which six were diagnosed with TB. The sensitivity and specificity of QFT-GIT were 75% and 81.3%. Nine (34.6%) were defined as noninfectious causes.
  
  
  CONCLUSIONS
  Causes of hepatic or splenic lesion in hematologic patients were diverse including TB, non-TB organisms, and noninfectious origins. TB should be considered for patients not responding to antibacterial or antifungal drugs, even in the absence of direct microbiological evidence. QFT-GIT may be useful for a differential diagnosis of hepatosplenic lesions in hematologic patients.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors.forename: Jae-Cheol
authors.initials: JC
authors.lastname: Kwon
authors.forename: Si-Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Park
authors.forename: Su-Mi
authors.initials: SM
authors.lastname: Choi
authors.forename: Dong-Gun
authors.initials: DG
authors.lastname: Lee
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Jin-Hong
authors.initials: JH
authors.lastname: Yoo
authors.forename: Yoo-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Seok
authors.initials: S
authors.lastname: Lee
authors.forename: Hee-Je
authors.initials: HJ
authors.lastname: Kim
authors.forename: Seok-Goo
authors.initials: SG
authors.lastname: Cho
authors.forename: Jong-Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Woo-Sung
authors.initials: WS
authors.lastname: Min
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005260:Female; D006402:Hematologic Diseases / Q000150:complications* / Q000401:mortality; D006801:Humans; D059425:Interferon-gamma Release Tests; D008100:Liver Abscess / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013158:Splenic Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality / Q000628:therapy
chemical_list: D000890:Anti-Infective Agents
keywords: Diagnosis; Hematology; Liver abscess; Tuberculosis