ABSTRACT
Tuberculosis (TB) of pancreas is a rare presentation in both immune-competent and immune-suppressed patients. Its presenting clinical features are usually vague and non-specific, while radiological features mimic other common pancreatic conditions such as malignancy, so it is often misdiagnosed. It commonly involves the head and the uncinate process of the pancreas. We report a middle-aged immune-compromised man who presented with left-sided tubercular pleural effusion and later was diagnosed as pancreatitis by clinical presentation and TB of pancreas on computed tomography of the abdomen.
Subject(s)
Pancreatic Diseases , Pleural Effusion , Tuberculosis , Humans , Male , Middle Aged , Pancreas , Pancreatic Diseases/diagnostic imaging , Pleural Effusion/diagnostic imaging , Tomography, X-Ray Computed , Tuberculosis/diagnosis , Tuberculosis/drug therapyABSTRACT
INTRODUCTION: Drug-induced immune hemolytic anemia (DIIHA) is a rare complication of any drug therapy, which if not recognized early can be fatal. It is usually underdiagnosed. Ceftriaxone is a commonly used antibiotic in routine practice and is one of the most common drugs to cause DIIHA. CASE PRESENTATION: We report a case of ceftriaxone-induced immune hemolytic anemia in a 62-year-old woman who had a negative result of a direct antiglobulin test. DISCUSSION: A review of the literature highlights the salient features of DIIHA and underscores the importance of keeping the suspicion of DIIHA high in the relevant clinical settings because ceftriaxone has been associated with particularly severe outcomes of DIIHA. In cases of unclear hemolysis and despite a negative result of a direct antiglobulin test, the treating physician must keep suspicion of DIIHA high and meticulously look for the possible culprit drugs. Treatment with suspected drugs must be stopped promptly to prevent severe complications and fatal outcomes.
