Paediatric Hepatic Haemangioma-A Rare Cause Of Pyrexia Of Unknown Origin

Area of Science:

• Pediatric Gastroenterology
• Hepatology
• Diagnostic Challenges

Background:

• Pyrexia of unknown origin (PUO) presents a significant diagnostic challenge due to its diverse and often elusive etiologies.
• Hepatic hemangioma (HH), a common benign liver tumor in children, is typically associated with vague abdominal pain and not commonly considered a cause of PUO.

Observation:

• A 4-year-old female presented with persistent low-grade fever and dull abdominal pain, initially posing a diagnostic dilemma.
• Extensive investigations were conducted to determine the cause of her prolonged fever.
• A drop in hemoglobin levels suggested a potential bleeding complication associated with the hepatic lesion.

Findings:

• The patient was diagnosed with hepatic hemangioma presenting as a cause of PUO.
• Treatment with prednisolone effectively reduced inflammatory markers.
• Surgical intervention (hepatectomy) was successfully performed, leading to the resolution of both the hepatic hemangioma and the pyrexia of unknown origin.

Implications:

• This case underscores the importance of considering uncommon causes, such as hepatic hemangioma, in the differential diagnosis of pediatric PUO.
• Early recognition and appropriate management of hepatic hemangioma can lead to favorable outcomes, resolving complex fevers.
• Highlights the successful integration of medical and surgical management for challenging pediatric cases.