International Journal of Medical Case Reports

Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

Castleman Disease Versus Generalized Tuberculosis: A Case of Fever of Unknown Origin

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis; it has a high prevalence in developing countries such as Peru. Although its most frequent clinical presentation is pulmonary, but it can damage any organ and have multisystem clinical manifestations. The gold standard for its diagnosis is the finding of the bacteria in the culture; however, the result of the same can take several weeks. We present the case of a 25 year old female patient with no significant clinical history, who was admitted due to various symptoms and signs, which was classified as fever of unknown origin after several weeks of studies and inconclusive test results. She presented multisystem involvement: lymph nodes, hepatic, gastrointestinal, hematological, pleural, and pulmonary. A biopsy of cervical lymphadenopathy was performed, and the pathology report was conclusive with Hyaline vascular variant Castleman's disease; however, the gastric aspirate culture study was positive for tuberculosis. A bibliographic search was carried out on the relationship between these two entities, finding that the diagnosis of tuberculosis rules out Castleman's disease. The patient received tuberculosis treatment for 6 months, with which she presented progressive improvement of clinical manifestations. In developing patients, it is important to consider that infectious diseases such as tuberculosis can have a very varied clinical presentation and multisystem involvement, which is why they should always be considered before other more rare ones.

Castleman Disease, Tuberculosis, Fever of Unknown Origin

APA Style

Edgard Niño Morin, Daniel Sánchez Morillos, Rafael Barreda Celis. (2023). Castleman Disease Versus Generalized Tuberculosis: A Case of Fever of Unknown Origin. International Journal of Medical Case Reports, 2(3), 20-23. https://doi.org/10.11648/j.ijmcr.20230203.12

ACS Style

Edgard Niño Morin; Daniel Sánchez Morillos; Rafael Barreda Celis. Castleman Disease Versus Generalized Tuberculosis: A Case of Fever of Unknown Origin. Int. J. Med. Case Rep. 2023, 2(3), 20-23. doi: 10.11648/j.ijmcr.20230203.12

AMA Style

Edgard Niño Morin, Daniel Sánchez Morillos, Rafael Barreda Celis. Castleman Disease Versus Generalized Tuberculosis: A Case of Fever of Unknown Origin. Int J Med Case Rep. 2023;2(3):20-23. doi: 10.11648/j.ijmcr.20230203.12

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Khan FMA, Kazmi Z, Hasan MM, dos Santos Costa AC, Ahmad S, Essar MY. Resurgence of tuberculosis amid COVID-19 in Peru: Associated risk factors and recommendations. Int J Health Plann Manage. 2021; 36 (6): 2441-5. URL available at: https://onlinelibrary. wiley.com/ doi /full/10.1002/hpm.3291
2. Flores-Ibarra AA, Dolores Ochoa-Vázquez M, Alejandra G, Tec.
3. S. Diagnostic strategies applied in the Tuberculosis Clinic of the General Hospital Centro Médico Nacional la Raza. Rev Med Inst Mex Seguro Soc. 2016; 54 (1): 122-7.
4. Fernandez GP. Head and neck tuberculosis. Acta Otolaryngol Esp. 2009; 60 (1): 59-66. URL available at: http://dx.doi.org/10.1016/ S0001-6519(09)70320-6
5. Anzures-Gómez PK, Camacho-Becerra C, Castro-Rubio JA, Rosas-Tototzintle R, Díaz-Castillo J, Abendaño-Rivera DF, González-González L, García-Juárez MA, Escutia-Cuevas HH, NavarroAlvarado R. Enfermedad de Castleman. Hematol Méx 2021; 22 (4): 225-231.
6. Siltuximab (Sylvant ®) Therapeutic Positioning Report in multicentric Castleman's disease. January 21, 2016. URL available at: https://www.aemps.gob. en/ medicamentosUsoHumano / informesPublicos / docs /IPT- siltuximab-Sylvant.pdf
7. González García A, Moreno Cobo M, Patier de la Peña JL. Diagnosis and current treatment of Castleman's disease. Rev Clin Esp. 2016 [cited 2021 Dec 25]; 216 (3): 146. 56. URL available at: https://www.revclinesp.es/es-diagnostico-tratamiento-actual-enfermedad-castleman-articulo-S0014256515002829
8. Dispenzieri A, Fajgenbaum DC. Overview of Castleman disease. Blood. 2020 Apr 16; 135 (16): 1353-1364. doi: 10.1182/blood.2019000931. PMID: 32106302.
9. Zlotogwiazda II, Leone CS, Cuba MA, Amado VA, Celso P, Ferronato F, Romay S. Enfermedad de Castleman multicéntrica y tuberculosis diseminada en paciente HIV positivo [Multicentric Castleman disease and tuberculosis in HIV positive patient]. Medicina (B Aires). 2023; 83 (2): 298-302. Spanish. PMID: 37094200.
10. Fajgenbaum DC, Uldrick TS, Bagg A, Frank D, Wu D, Srkalovic G, et al. International, evidence-based consensus diagnose criteria for HHV-8-negative/ idiopathic multicentric Castleman disease. Blood. 2017; 129 (12): 1646-57. URL available at: https://pubmed. ncbi.nlm.nih.gov/28087540/
11. Yoshizaki, K., Murayama, S., Ito, H., & Koga, T. (2018). The Role of Interleukin-6 in Castleman Disease. Hematology/Oncology Clinics of North America, 32 (1), 23–36. doi: 10.1016/j.hoc.2017.09.003.
12. Carow B, Rottenberg ME. SOCS3, a major regulator of infection and inflammation. Front Immunol. 2014; 5 (Feb): 1-13.
13. Alves ACFPB, Prado AIF, Takenami I. Imunologia da tuberculose: uma revisão narrativa da literatura. Arq Asma Alerg Imunol. 2022; 6 (2): 239-50.
14. Yoshizaki K, Murayama S, Ito H, Koga T. The Role of Interleukin-6 in Castleman Disease. Hematol Oncol Clin North Am. 2018; 32 (1): 23-36. URL available at: https://pubmed.ncbi.nlm.nih.gov/29157617/
15. Ide M, Yokoyama T, Ogino T. Tuberculous lymphadenitis mimicking Castleman disease-like histological features. Int J Hematol. 2019; 109 (3): 245-6. URL available at: https://link.springer.com/ article /10.1007/s12185-018-02579-6