MRI-findings of nodular lesions in an enlarged spleen, associated with visceral Leishmaniasis

Raeymaeckers, Steven; Docx, M.; Demeyere, Nathan

doi:10.1016/j.ejrad.2011.11.021

Cited by 17 publications

(16 citation statements)

References 5 publications

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“…Lymphadenopathy can be observed. The presence of multiple nodular masses in the liver and spleen has been reported, but the parenchyma is usually homogeneous [23,24]. Spleen lesions are hypoechogenic in the sonogram, hypointense in the T2-weighted MRI and hypointense in the CT compared to the other parenchyma [19,20].…”

Section: Visceral Leishmaniasismentioning

confidence: 99%

Radiological Diagnoses in the Context of Emigration: Infectious diseases

Stojković

Müller

Junghanss

et al. 2017

Fortschr Röntgenstr

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Background Globalization and emigration impact on the spectrum of diseases challenging health care systems. Medical practitioners have to particularly prepare for infectious diseases. Methods The database of a health care center specialized on tropical medicine was screened for patients with history of migration and one of the following diagnoses: Cystic echinococcosis, tuberculosis, schistosomiasis, visceral leishmaniosis, and neurocysticercosis. Representative casuistics were prepared from select case histories. Radiological pertinent knowledge was compiled based on literature search. Results A small selection of frequently imported infectious diseases covers a considerable fraction of health care problems associated with migration. For cystic echinococcosis, schistosomiasis, and neurocysticercosis imaging is the most relevant diagnostic procedure defining also disease stages. Tuberculosis and visceral leishmaniosis are important differentials for malignant diseases. Conclusion Imaging plays a meaningful role in diagnosis, treatment stratification, and follow-up of imported infectious diseases. Radiological skills concerning these diseases are important for providing health care for patients in context of migration. Key Points Citation Format

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Section: Visceral Leishmaniasismentioning

confidence: 99%

Radiological Diagnoses in the Context of Emigration: Infectious diseases

Stojković

Müller

Junghanss

et al. 2017

Fortschr Röntgenstr

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“…Ultrasonography, CT and MRI detect multiple hypoechoic/hypodense nodules in the spleen. However, these images are non-specific and can be detected in septic emboli or abscesses, splenic infarction, metastatic disease, lymphoma, and granulomatous inflammatory diseases such as mycobacterial, fungal infections, cat-scratch disease, and sarcoidosis, as well as VL (6,(8)(9)(10)16). Most of our patients (7/10 patients) had multiple hypodense nodules in the spleen in which the parenchyma was usually homogeneous.…”

Section: Conflict Of Interestmentioning

confidence: 80%

“…Besides, in the fourth patient who was on steroid treatment and died, the first serological test (rK39 rapid immunochromatographic test) was negative, and amastigotes could not be demonstrated in the first BM aspirate. Except for a few publications in recent years, abdominal imaging is limited in the use for diagnosis of VL (7)(8)(9). During VL, the spleen is one of the most affected organs, and splenomegaly develops.…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…Although radiological signs of VL are non-specific, many patients with VL had pronounced hepatosplenomegaly and intraabdominal lymphadenopathy (6). Additionally, recent reports state that multiple hypodense nodules in the spleen are present which are superimposed to homogeneous parenchyma in abdominal computed tomography (CT) or magnetic resonance imaging (MRI) (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

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Multiple Nodular Lesions in Spleen and Liver in Visceral Leishmaniasis

Kutlu

Herek

et al. 2019

Infect Dis Clin Microbiol

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Objective:We aimed to describe the clinical, laboratory, and radiological characteristics of visceral leishmaniasis (VL) in our region to find additional clues that can help diagnosis. Materials and Methods:All the patients with VL who admitted to our clinic between January 2010 and January 2018 were reviewed retrospectively. The patients with symptoms and signs suggestive of VL and a positive indirect fluorescent antibody test (IFA) or rapid diagnostic test, and/or direct parasitology consisting of the presence of amastigotes of Leishmania in bone marrow aspirate were included in the study. We collected the demographic and clinical features, laboratory, and radiological information from the hospital database. Results:We present ten (seven males and three females) cases of VL, with the mean age of 53 (range of 31-75). Serological tests such as IFA or rapid diagnostic tests were positive in all patients. Amastigotes of Leishmania were present in only three of eight patients who underwent bone marrow biopsy. Abdominal magnetic resonance imaging or computed tomography revealed that all patients (10/10) had splenomegaly, eight of 10 patients had hepatomegaly, and seven patients had intraabdominal lymphadenopathy. Seven patients had multiple hypodense nodular lesions in the spleen with homogeneous parenchyma. Two patients had nodular lesions in the liver. Two patients died because of multiorgan failure before completing their treatment. The remaining patients completed liposomal amphotericin B treatment and cured.Conclusion: VL should be suspected in the diagnosis of the patients, who had long-term fever, splenomegaly, pancytopenia associated with multiple nodular lesions in the spleen with/without liver involvement.

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“…Her nodules had completely resolved four months after the start of the treatment. 7 Our patient was presented prolonged and intermittent fever with splenic nodules. Delays in diagnosis of VL are common because of variable incubation time.…”

Section: Discussionmentioning

confidence: 99%

Visceral Leishmaniasis with Splenic Nodules: Case Report

Alkan¹,

Kara²,

Özen³

2016

Turkiye Klinikleri J Pediatr

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56isceral leishmaniasis (VL) is a systemic parasitic disease that is caused by the Leishmania donovani (South Asia and East Africa) or Leishmania infantum (Mediterranean basin, Middle East, Western Asia and Brazil) and is transmitted by sand flies (genus Phlebotomus). Fever and splenomegaly are detected in more than 80% of patients as the most common clinical manifestations. Neutropenia, anemia, thrombocytopenia, elevated sedimentation and hypergammaglobulinemia are the most common laboratory abnormalities of this disease. Without treatment VL is nearly always lethal due to infectious and haemorrhagic complications. [1][2][3] Visceral Leishmaniasis with Splenic Nodules: Case Report A AB BS ST TR RA AC CT T Visceral leishmaniasis (VL) is transmitted to humans by the bite of sandflies. VL is an endemic parasitic disease which is characterized by fever, splenomegaly and pancytopenia in most of the cases. Delays in diagnosis of VL are common because of nonspecific symptoms and variable incubation time. Specific serology and polymerase chain reaction are useful for the diagnosis. Anti-K39 strip test is highly sensitive. Splenic multifocal hypoechoic nodules should be evaluated for VL with clinical and laboratory features in patient. Herein we report a twenty-two month-old female infant with diagnosis of VL who presented with recurrent fever, pancytopenia and ultrasonography revealed enlarged spleen with multifocal hypoechoic nodules. We considered that splenic nodules can help to diagnosis of VL in children as literature case reports support to this situation. K Ke ey y W Wo or rd ds s: : Fever; pancytopenia; leishmaniasis, visceral Ö ÖZ ZE ET T Visseral leishmaniasis (VL) insanlara dişi kum sineklerinin (sandfly) ısırmasıyla bulaşmak-tadır. VL olguların çoğunluğunda gözlenen ateş, splenomegali ve pansitopeni ile karakterize, endemik paraziter bir hastalıktır. Özgül olmayan semptomlar ve değişken inkübasyon süresinden dolayı tanıda gecikme sıktır. Özgül serolojik testler ve polimeraz zincir reaksiyonları tanıda kullanılmaktadır. Anti-K39 testinin duyarlılığı çok yüksektir. Klinik ve laboratuar bulguları uyumlu olan hastalarda ultrasonografide görülen dalaktaki çoklu sayıda hipoekoik nodüller VL'ı akla getirmelidir. Bu olgu sunumunda tekrarlayan ateş, pansitopenisi olan, ultrasonografide dalak büyük-lüğü ve çok sayıda hipoekoik nodüller saptanan yirmi iki aylık bir kız hastayı sunduk. Biz olgumuz ve literatürde yayımlanmış olan vaka sunumları ışığında, dalakta saptanan nodüllerin çocuklarda VL tanısı koymada yardımcı olabileceği düşüncesindeyiz.A An na ah ht ta ar r K Ke el li im me el le er r: :Ateş; pansitopeni; leşmanyazis, visseral T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J P Pe ed di ia at tr r 2 20 01 16 6; ;2 25 5( (1 1)

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MRI-findings of nodular lesions in an enlarged spleen, associated with visceral Leishmaniasis

Cited by 17 publications

References 5 publications

Radiological Diagnoses in the Context of Emigration: Infectious diseases

Radiological Diagnoses in the Context of Emigration: Infectious diseases

Multiple Nodular Lesions in Spleen and Liver in Visceral Leishmaniasis

Visceral Leishmaniasis with Splenic Nodules: Case Report

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