PT  - JOURNAL ARTICLE
AU  - Chouairy, Camil J.
AU  - Bechara, Elie A.
AU  - Gebran, Sleiman J.
AU  - Ghabril, Ramy H.
TI  - Inflammatory myofibroblastic tumor of the mesentery associated with high fever and positive Widal test
DP  - 2008 Dec 01
TA  - Saudi Medical Journal
PG  - 1819--1823
VI  - 29
IP  - 12
4099  - http://smj.org.sa/content/29/12/1819.short
4100  - http://smj.org.sa/content/29/12/1819.full
SO  - Saudi Med J2008 Dec 01; 29
AB  - Inflammatory myofibroblastic tumor (IMT) is associated in 15-30% of cases with systemic symptomatology, such as prolonged fever, weight loss, elevated erythrocyte sedimentation rate (ESR), anemia, thrombocytosis, and leukocytosis. We report the case of a 4-year-old Lebanese boy who presented with high-grade fever of long duration, and a single (unpaired) positive Widal agglutination test. Blood culture was negative. A diagnosis of typhoid fever was made. An abdominal (mesenteric) IMT was incidentally discovered, 30 days after the fever had appeared. After surgery, the fever disappeared immediately, and the ESR returned to normal. We strongly favor the possibility of a false positive Widal test, due to polyclonal increase in serum immunoglobulins, which often occurs in IMT. We also think that IMT might be a mimicker of typhoid fever, both clinically and serologically. Physicians, especially pediatricians practicing in endemic areas, should probably be aware of this mimicry.