Peer-influenced content. Sources you trust. No registration required. This is HCN.

The New England Journal of MedicineA 58-Year-Old Woman with Fatigue, Abdominal Bloating, and Eosinophilia

Unfolding a Clinical Enigma: From a Tibia Fracture in Congo to Mysterious Symptoms

A Case Challenge study of a 58-year-old female who, after sustaining a tibia fracture in the Democratic Republic of Congo (DRC), started experiencing persistent fatigue, abdominal bloating, and elevated eosinophil counts, ignites a journey into the intricacies of infectious disease diagnosis and management. After reading, what’s your diagnosis?

  • The woman presented with fatigue, abdominal bloating, and eosinophilia, eight months post tibia fracture in the DRC
  • The patient’s eosinophil count had escalated to 3,530 per microliter, significantly beyond the normal reference range (0-400), whereas it had been normal 18 months earlier.
  • Following her leg injury, her pre-existing symptoms of weight gain and fatigue intensified; she gained 13.6 kg and started taking afternoon naps due to fatigue.
  • Calcified lesions in the right lung, liver, and spleen, suggestive of granulomatous disease, were revealed in a CT scan, along with a probable hepatic cyst.
  • Tests for common infections, such as syphilis, HIV, and strongyloidiasis, returned negative results.
  • Blood tests for thyroid, kidney, and liver functions were within normal limits, and a test for Lyme disease was also negative.
  • The patient had a history of chronic migraines and hyperlipidemia, with no significant past of fever, abdominal pain, or arthralgias.
The Healthcare Communications Network is owned and operated by IQVIA Inc.

Click below to leave this site and continue to IQVIA’s Privacy Choices form