Abstract :

Pediatric cancers have the ability to spread rapidly, however, they also respond well to chemotherapy, and can have incredible success rates when diagnosis and intervention are implemented early. This case report describes an unusual presentation of B-ALL in a patient whose treatment was initially delayed due to barriers of cultural origin. The child initially presented with high fevers and vomiting, with mild abdominal distention and tenderness. With concern for sepsis or the need for surgical intervention, the pediatrician urged the family to proceed to a tertiary care center for further workup. The family felt these processes were unnecessary and felt that he would recover at home with over-the-counter medications. As the boy remained ill, emergency care was sought, and further investigations revealed a diagnosis of B-cell acute lymphoblastic leukemia. With this case report, we examine the importance of diagnostic vigilance amongst physicians to ensure a prompt and accurate diagnosis, while remaining mindful of cultural factors that may complicate clinical assessment and compliance.

---

Keywords :

B-ALL, cultural barriers, diagnostic vigilance, Pediatric Oncology., Rural healthcare

---

References :

1. Bousfield da Silva D, Pianovski M, Fonseca da Costa Childhood and adolescent cancer: early diagnosis challenges. Revista da Associação Médica Brasileira. 2024 Jan 1;70(suppl 1).
2. Acute Lymphoblastic Leukemia [Internet]. org. Available from: https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia
3. Inaba H, Mullighan Pediatric acute lymphoblastic leukemia. Haematologica. 2020 Sep 10;105(11).
4. Abuelezam NN, El-Sayed AM, Galea The Health of Arab Americans in the United States: An Updated Comprehensive Literature Review. Frontiers in Public Health. 2018 Sep 11;6(262).
5. Ali HT, Barakat M, Abdelhalim AR, Al-Kurd IN, Muhammad MKE, Sharkawy MM, et Unravelling the dilemma of self-medication in Egypt: a cross-sectional survey on knowledge, attitude, and practice of the general Egyptian population. BMC public health. 2024 Mar 1;24(1).
6. Ladines-Lim J, Scruggs-Wodkowski E, Adžemović T, Croxton R, Romero R, Lukela M, et Understanding refugee and immigrant health literacy and beliefs toward antimicrobial resistance. Antimicrobial Stewardship & Healthcare Epidemiology [Internet]. 2023 Jan 1 [cited 2024 Jan 19];3(1):e175. Available from: https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/understanding-r efugee-and-immigrant-health-literacy-and-beliefs-toward-antimicrobial-resistance/9FE10FE37B1FF372168B6862CF3B 27F0
7. Lescure DLA, van Oorschot W, Brouwer R, van der Velden J, Tjon-A-Tsien AML, Bonnema IV, et Providing antibiotics to immigrants: a qualitative study of general practitioners’ and pharmacists’ experiences. BMC Primary Care. 2022 May 2;23(1).