A Sudanese man in his early 40s was admitted to our tertiary healthcare centre with a 3-month history of abdominal pain, fevers and intermittent diarrhoea on the background of a known bladder lesion awaiting a transurethral resection. The patient denied any other constitutional symptoms and did not have any other significant medical history.

On examination, the patient was febrile, but otherwise haemodynamically stable. There was bilateral cervical and left supraclavicular lymphadenopathy with generalised abdominal tenderness without any palpable masses.

Admission laboratory investigations demonstrated iron-deficiency anaemia: haemoglobin 83 g/L (130–180 g/L); iron <2 µmoI/L (11–3 2 µmoI/L) and ferritin 28 µg/L (30–340 µmoI/L) with a mild C reactive protein rise of 22 mg/L …