2016, Number 6
Fever, thrombocytopenia, hepatic tumor and pulmonary embolism: a complex case handled by internists
Carriel-Mancilla J, Lozano-Parras MÁ, Calvo-Manuel E, Suárez-Acosta C
Language: Spanish
References: 0
Page: 688-693
PDF size: 252.47 Kb.
ABSTRACT
This paper reports the case of an 86-year-old male, who presented fever and neurological impairment secondary to Listeria monocytogenes bacteremia after cycle of dexamethasone for deterioration of idiopathic thrombocytopenic purpura, diagnosed over 30 years, which has been treated over 10 years with danazol. Listeriosis is a rare disease with an incidence of 0.8/100,000 habitants and 20% mortality with treatment, observed in patients with certain state of immunosuppression as those in our patient (age, corticosteroids, diabetes mellitus). Also, in imaging tests performed by elevation of liver enzymes, we found a lesion compatible with hepatocellular carcinoma. Chronic intake of danazol was the only recognizable cause for the liver tumor. During admission patient developed hemorrhagic complications secondary to severe thrombocytopenia and concomitantly a thrombotic process with incidental finding of pulmonary thromboembolism forcing multidisciplinary management.