A 70-year-old Hispanic male with fever of an unknown origin was transferred to a convalescent hospital from a chronic care hospital. However, his condition worsened. During his treatment in the chronic care hospital, he had received combination antibiotic treatment for sepsis from the respiratory origin, acute renal failure, and secondary digital toxicity. He was diagnosed with probable myelodysplastic syndrome. On further examination, he presented with intense sarcopenia.
His cardiopulmonary exploration was normal, no visceromegaly in abdominal exploration and estimated LVEF in clinical ultrasound was around 45%, and the absence of pleural effusion with moderate mitral insufficiency. Blood tests revealed 200 lymphocytes with 0 neutrophils and severe thrombocytopenia. Serological tests were negative for HIV, HCV, HBV, and CMV. Serology was positive for Leishmania, and sternal bone…
