RT Journal Article
SR Electronic
T1 Inflammatory myofibroblastic tumor of the mesentery associated with high fever and positive Widal test
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1819
OP 1823
VO 29
IS 12
A1 Chouairy, Camil J.
A1 Bechara, Elie A.
A1 Gebran, Sleiman J.
A1 Ghabril, Ramy H.
YR 2008
UL http://smj.org.sa/content/29/12/1819.abstract
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.