Inflammatory myofibroblastic tumor of the mesentery associated with high fever and positive Widal test

Authors

• Camil J. Chouairy, Pathology Department, Saint George Hospital, Youssef Sursock Street, Rmeil, Achrafieh, PO Box 166378, Beirut 11002807, Lebanon. E-mail: camil.chouairy{at}balamand.edu.lb
• Elie A. Bechara, Pathology Department, Saint George Hospital, Youssef Sursock Street, Rmeil, Achrafieh, PO Box 166378, Beirut 11002807, Lebanon. E-mail: camil.chouairy{at}balamand.edu.lb
• Sleiman J. Gebran, Pathology Department, Saint George Hospital, Youssef Sursock Street, Rmeil, Achrafieh, PO Box 166378, Beirut 11002807, Lebanon. E-mail: camil.chouairy{at}balamand.edu.lb
• Ramy H. Ghabril, Pathology Department, Saint George Hospital, Youssef Sursock Street, Rmeil, Achrafieh, PO Box 166378, Beirut 11002807, Lebanon. E-mail: camil.chouairy{at}balamand.edu.lb

Abstract

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.

Article Type

Case Report

First Page

1819

Last Page

1823

Recommended Citation

Chouairy, Camil J.; Bechara, Elie A.; Gebran, Sleiman J.; and Ghabril, Ramy H. (2008) "Inflammatory myofibroblastic tumor of the mesentery associated with high fever and positive Widal test," Saudi Medical Journal: Vol. 29: Iss. 12, Article 26.
DOI: https://doi.org/10.15537/1658-3175.4581