Diagnostic Dilemma


A 7 years old boy had fever with limping 4 months back and left hip arthritis was detected for which arthrotomy was done and pus smear showed acid fast bacilli {AFB}. He was started on 4 drug antituberculous therapy {ATT}. His culture also grew mycobacterium tuberculosis {MTB} sensitive to all first line drugs. His hemogram 4 months ago showed lymphopenia {882 cells, cumm} which again after 4 months of therapy was 1364 cells, cumm. HIV ELISA was negative.

What is the cause of lymphopenia_?
Expert Opinion :
Tuberculosis is one of the numerous conditions that may temporarily diminish lymphocyte subpopulations, producing the lymphocytopenia observed in some patients. Lymphopenia in patients with Tb is unrelated to the extent of lesions and prognosis. However it could be associated to a higher frequency of paradoxical reactions
Answer Discussion :
Abdul Rashid
Refractory lymphopenia due to severe infection
12 years ago
from tuberculous infection
12 years ago

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