Hemophagocytosis and granulomas in the bone marrow of a child with down syndrome

Vishwas S. Sakhalkar, Sreedhar P. Rao, Susan R.S. Gottessman, Scott T. Miller

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Persistent fever with pancytopenia and hepatomegaly with negative blood cultures and no obvious focus of infection in a child with Down syndrome should arouse a suspicion of leukemia. Bone marrow examination and clot biopsy from one such patient revealed hemophagocytosis and granulomas, with serologic evidence of recent Epstein-Barr virus infection. Bone marrow granulomas are not a feature of Epstein-Barr infection. Later, bone marrow culture and repeat blood culture grew Salmonella typhi. Thus, in a febrile child, when performing a bone marrow aspirate, a clot biopsy and culture for infectious etiology may be helpful, even when leukemia is strongly suspected.

Original languageEnglish (US)
Pages (from-to)623-625
Number of pages3
JournalAmerican Journal of Pediatric Hematology/Oncology
Issue number9
StatePublished - 2001
Externally publishedYes


  • Down syndrome
  • Granuloma
  • Hemophagocytic lymphohistiocytosis
  • Pancytopenia
  • Salmonella typhi

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


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