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

  • I. D. Khan Assistant Professor, Clinical Microbiology and Infectious Diseases, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India http://orcid.org/0000-0002-9824-8711
  • M. Malik ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • K. S. Rajmohan ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • P. Banerjee ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • S. Khan ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • P. S. Panda ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • M. Brijwal ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • S. Gupta ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • K. Kahkasha ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • S. Gazala ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • E. Sawarat ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
  • M. S. Aguinaga ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA
Keywords: hemophagocytosis, pharyngeal abscess, Acinetobacter baumanii, pancytopenia, ventilator-associated pneumonia, sepsis.

Abstract

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.

Author Biography

I. D. Khan, Assistant Professor, Clinical Microbiology and Infectious Diseases, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

Assistant Professor, Clinical Microbiology and Infectious Diseases, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

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Published
2018-07-25
How to Cite
Khan, I., Malik, M., Rajmohan, K., Banerjee, P., Khan, S., Panda, P., Brijwal, M., Gupta, S., Kahkasha, K., Gazala, S., Sawarat, E., & Aguinaga, M. (2018). HEMOPHAGOCYTOSIS SECONDARY TO PHARYNGEAL ABSCESS IN AN IMMUNOCOMPETENT PATIENT (case report). International Journal of Medicine and Medical Research, (1). https://doi.org/10.11603/ijmmr.2413-6077.2018.1.8514
Section
Anesthesiology and Critital Care