Prolonged Fever, Hepatosplenomegaly, and Pancytopenia in a 46-Year-Old Woman

Abstract

A 46-year-old woman was hospitalized due to fever of up to 39uC of one week's duration. The patient complained of weakness, night sweats, and weight loss for two weeks prior to admission. The patient had no past medical history, and did not take any medications, supplements, or illicit drugs. She was born and lived all her life in a rural village. She was indirectly exposed to farm animals and pets, yet had no close contact with these, and her family was not engaged in agricultural work. She denied having been bitten by ticks or fleas. There was no history of recent foreign travel or eating raw meat or unpasteurized milk. She reported no rashes, arthralgia, dryness of eyes, mouth ulcers, or mucocutaneous bleeding.