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. 1984 Sep-Oct;57(5):787–795.

Fever, jaundice, and histiocytic erythrophagocytosis: fulminant infection or malignancy?

D F Heiman, M Haas, J K Griffiths, F J Bia
PMCID: PMC2589652  PMID: 6523907

Abstract

Some of the problems which we see on the infectious disease consultation service can be quite frustrating. This is one such case. A middle-aged man presented to our medical service with fever and dyspnea. His fulminant downhill course was characterized by anemia, jaundice, hypercalcemia, pulmonary abnormalities, and a lack of responsiveness to conventional antimicrobial therapy. At autopsy, malignant-appearing histiocytes were present in several organs including spleen, lymph nodes, and lung. Histopathological examination of tissues obtained at autopsy confirmed the presence of phagocytized erythrocytes within such histiocytes. This case aptly illustrates the hazy dividing line which sometimes exists between infectious and/or malignant processes which are, at present, still of undetermined etiology.

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Selected References

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  1. Abbasi A. A., Chemplavil J. K., Farah S., Muller B. F., Arnstein A. R. Hypercalcemia in active pulmonary tuberculosis. Ann Intern Med. 1979 Mar;90(3):324–328. doi: 10.7326/0003-4819-90-3-324. [DOI] [PubMed] [Google Scholar]
  2. BOAKE W. C., CARD W. H., KIMMEY J. F. HISTIOCYTIC MEDULLARY RETICULOSIS; CONCURRENCE IN FATHER AND SON. Arch Intern Med. 1965 Aug;116:245–252. doi: 10.1001/archinte.1965.03870020085016. [DOI] [PubMed] [Google Scholar]
  3. Cohen R. A., Hutter J. J., Jr, Boxer M. A., Goldman D. S. Histiocytic medullary reticulosis associated with acute Epstein-Barr (EB) virus infection. Am J Pediatr Hematol Oncol. 1980 Fall;2(3):245–248. [PubMed] [Google Scholar]
  4. Lampert I. A., Catovsky D., Bergier N. Malignant histiocytosis: a clinico-pathological study of 12 cases. Br J Haematol. 1978 Sep;40(1):65–77. doi: 10.1111/j.1365-2141.1978.tb03640.x. [DOI] [PubMed] [Google Scholar]
  5. Lee J. C., Catanzaro A., Parthemore J. G., Roach B., Deftos L. J. Hypercalcemia in disseminated coccidioidomycosis. N Engl J Med. 1977 Aug 25;297(8):431–433. doi: 10.1056/NEJM197708252970808. [DOI] [PubMed] [Google Scholar]
  6. McKenna R. W., Risdall R. J., Brunning R. D. Virus associated hemophagocytic syndrome. Hum Pathol. 1981 May;12(5):395–398. doi: 10.1016/s0046-8177(81)80019-6. [DOI] [PubMed] [Google Scholar]
  7. Parker M. S., Dokoh S., Woolfenden J. M., Buchsbaum H. W. Hypercalcemia in coccidioidomycosis. Am J Med. 1984 Feb;76(2):341–344. doi: 10.1016/0002-9343(84)90799-x. [DOI] [PubMed] [Google Scholar]
  8. Risdall R. J., McKenna R. W., Nesbit M. E., Krivit W., Balfour H. H., Jr, Simmons R. L., Brunning R. D. Virus-associated hemophagocytic syndrome: a benign histiocytic proliferation distinct from malignant histiocytosis. Cancer. 1979 Sep;44(3):993–1002. doi: 10.1002/1097-0142(197909)44:3<993::aid-cncr2820440329>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  9. Warnke R. A., Kim H., Dorfman R. F. Malignant histiocytosis (histiocytic medullary reticulosis). I. Clinicopatholigic study of 29 cases. Cancer. 1975 Jan;35(1):215–230. doi: 10.1002/1097-0142(197501)35:1<215::aid-cncr2820350127>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]

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