HEMOPHAGOCYTOSIS SECONDARY TO PHARYNGEAL ABSCESS IN AN IMMUNOCOMPETENT PATIENT (case report)

• Published in: International journal of medicine and medical research no. 1
• Main Authors: Khan, I. D., Malik, M., Rajmohan, K. S., Banerjee, P., Khan, S., Panda, P. S., Brijwal, M., Gupta, S., Kahkasha, K., Gazala, S., Sawarat, E., Aguinaga, M. S.
• Format: Journal Article
• Language: English
• Published: Ukrmedknyha 25-07-2018
• Subjects: Acinetobacter baumanii; hemophagocytosis; pancytopenia; pharyngeal abscess; sepsis; ventilator-associated pneumonia
• DOI: 10.11603/ijmmr.2413-6077.2018.1.8514
• EISSN: 2414-9985
• ISSN: 2413-6077

Background. Hemophagocytosis is a rare, potentially fatal disorder, comprising pancytopenia, liver dysfunction, hepatosplenomegaly, hypertriglyceridemia, and hyperferritinemia presenting as fever, lympha­denopathy and skin rashes. Objective. To attract the clinicians’ attention to a problem of hemophagocytosis in Critical Care management.Methods. Hemophagocytosis secondary to pharyngeal abscess in a 58 year old male is being reported.Results. A 58-year-old immunocompetent patient presenting with hemophagocytosis secondary to pharyngeal abscess, was managed on ventilator and inotropic support, when he developed heathcare-associated urinary tract infection by Escherichia coli and ventilator-associated pneumonia by Acinetobacter baumanii. He developed neutropenic septic shock and multi-organ dysfunction and went through a downhill course leading to demise.Conclusions. Hemophagocytosis remains a sinister entity in modern intensive care despite astute clinical management. Secondary superinfections with opportunistic multidrug resistant pathogens are difficult to treat. A high index of clinical suspicion, aggressive diagnosis and prompt treatment for hemophagocytosis and polymicrobial opportunistic superinfections with multidrug-resistant healthcare-associated pathogens needs to be addressed upfront.