2024/12/31 by Khlayfia, Z., Abdelmlak R, Azzabi O +7
#Fièvre prolongée #Prolongedfever #child #enfant #neuroblastoma #neuroblastome #tuberculose #tuberculosis
paper · doi:10.71566/pist-rmp-194805
Aim:Wereportthecaseofneuroblastomaina4-year-oldgirlrevealedbyprolongedfever. Casreport:Fouryearoldgirl,withoutantecedents,wasadmittedforexplorationofaprolongedfever. The clinical examinationwaswithout abnormalities. The initial biological assessment showed: an inflamma- torysyndrome,annormochromicnormocyticanemiawithanegativeTCD,anormalhepaticevaluation,a negativebacteriologicalassessment(PL,ECBU,HC)andnobiologicalabnormalityinfavorofatumor. The myelogramwaswithoutabnormalities. Nonspecificinfectionswerequicklyeliminatedbythefirst-lineassess- ment. Giventhelackofcriteriaforamacrophageactivationsyndromeoraninflammatoryoriginoffeverand thepresenceofcoelio-mesentericadenopathiesandanintraperitonealeffusionoflowabundanceonthe abdominalultrasound,theInfectious(especiallyabdominal)andtumoraloriginhavebeenstronglysuspected. Athoraco-abdominopelvicCTconcludedtotoretroperitoneallymphadenopathysuggestiveofabdominal tuberculosis. laparoscopywas performed showing serous pelvic effusion oflowabundancewith centimetric lymphadenopathyattheilealocecaljunction. Whilewaitingforthebiopsyresultandinviewofthehighclinical presumptionoftuberculosiswith(CA125elevation),antituberculoustreatmentwasstartedbutquicklystop- pedintheabsenceofaclinicalresponseandbecauseofthenegativetuberculosisassessmentandtheanatomopathologicalexaminationwhichconcludedto reactionganglion. Atumorcausewasthen strongly suspected,andthedosageofmethoxylatedderiva- tivesofurinarycatecholaminesreturningstrongly positive andthe Osteo-medullarybiopsyconfirmed thediagnosisofneuroblastoma. Thechildwasthen transferredtoaspecializedpediatriconcologyde- partment to begin chemotherapy. Conclusion:Inthe case ofunexplained prolonged feverinachildwhoismostlyundertheageof5,the diagnosis of neuroblastoma, which may sometimes bedifficulttodetectinconventionalimaging,must be referred to systematically. tomopathologicalexaminationwhichconcludedto reactionganglion. Atumorcausewasthen strongly suspected,andthedosageofmethoxylatedderiva- tivesofurinarycatecholaminesreturningstrongly positive andthe Osteo-medullarybiopsyconfirmed thediagnosisofneuroblastoma. Thechildwasthen transferredtoaspecializedpediatriconcologyde- partment to begin chemotherapy. Conclusion:Inthe case ofunexplained prolonged feverinachildwhoismostlyundertheageof5,the diagnosis of neuroblastoma, which may sometimes bedifficulttodetectinconventionalimaging,must be referred to systematically. tomopathologicalexaminationwhichconcludedto reactionganglion. Atumorcausewasthen strongly suspected,andthedosageofmethoxylatedderiva- tivesofurinarycatecholaminesreturningstrongly positive andthe Osteo-medullarybiopsyconfirmed thediagnosisofneuroblastoma. Thechildwasthen transferredtoaspecializedpediatriconcologyde- partment to begin chemotherapy. Conclusion:Inthe case ofunexplained prolonged feverinachildwhoismostlyundertheageof5,the diagnosis of neuroblastoma, which may sometimes bedifficulttodetectinconventionalimaging,must be referred to systematically.