Nimrah Fatima1, Khatidja Ally1, Hira waseem1, Hina Rajani1, Ashar Masood Khan2.
1National institute of child health, Karachi, Pakistan,
2Dr Ziauddin University hospital, Karachi, Pakistan.
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Abstract
Brucellosis is an important but neglected cause of febrile illness in children in areas with high exposure to animals or unpasteurized milk and dairy products. Pyrexia of unknown origin has multiple causes and underlying conditions in paediatric population including multiple infectious, autoimmune, and malignant conditions. Although closely mimicking but some of these conditions can co-exist in a single patient as in our case and a second diagnosis should always be kept in mind in initially improved but then deteriorating patients. Our patient was an eight years old male child who presented with a systemic illness involving lymphadenopathy, hepatospleenomegaly and signs of CNS involvement. He came out to be positive for B.Melitensis and APLA antibodies. He was treated with combination therapy of Rifampicin, doxycycline and oral steroids. Even though his initial workup was negative for any malignancy and he responded to the initial treatment but the recurrence of symptoms and deterioration in his general condition led us to repeat some of his investigation which later on came out to be positive for non-Hodgkin’s T cell Lymphoma (peripheral T cell Lymphoma).
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