From the Departments of Pathology (Drs Savell and Parham) and Pediatrics (Dr Jacobs), University of Arkansas for Medical Sciences, and Arkansas Children's Hospital, Little Rock.
A PREVIOUSLY HEALTHY 5-year-old Hispanic girl presented with a 4-month history of fever and night sweats and a recent onset of abdominal swelling and anorexia. She had traveled to Mexico 13 months previously and had otherwise been living in Texas and Arkansas. She did not have a cough, vomiting, or diarrhea but had a history of consumption of pork and goat's milk. Findings from physical examination were remarkable for hepatosplenomegaly. Findings from a bone marrow examination revealed normal hematopoiesis with scattered ill-defined aggregates of foamy histiocytes (Figure 1). A biopsy of the bone marrow core was performed (Figure 2 and Figure 3). Blood cultures and serologic titers were positive for a bacterial organism.
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