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Fever and Leg Pain: Consider ALL the Diagnoses.
Lesley N Desmond1, Matthew B Fletcher2, Rajasekharan P Warrier1,2
1The University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA.
Acute lymphoblastic leukemia (ALL) can mimic osteomyelitis in children. Early diagnosis and broad differential diagnosis are crucial for effective treatment of pediatric ALL presenting with leg pain and fever.
Area of Science:
- Pediatric Oncology
- Hematology
Background:
- Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer in the US.
- ALL can impair hematopoiesis, leading to anemia, thrombocytopenia, and leukopenia.
- Symptoms of ALL can overlap with other conditions, including osteomyelitis.
Observation:
- A 2-year-old male presented with leg pain and fever, initially diagnosed as bilateral osteomyelitis.
- Antibiotic treatment for osteomyelitis failed to resolve the symptoms.
- Bone marrow aspiration revealed CD99 membrane-positive small round blue cell tumors.
Findings:
- The patient was diagnosed with Acute lymphoblastic leukemia (ALL).
- The patient achieved remission after chemotherapy treatment.
- CD99 expression can be a marker in pediatric ALL.
Implications:
- This case highlights the importance of considering ALL in the differential diagnosis of pediatric leg pain and fever.
- A broad diagnostic approach is essential to avoid delayed diagnosis of pediatric malignancies.
- Prompt diagnosis and treatment of ALL are critical for favorable outcomes in children.
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