Fatal hemophagocytic lymphohistiocytosis-induced multiorgan dysfunction secondary to Burkholderia pseudomallei sepsis: A case report  

作　　者：Ming-Ze Sui Ke-Cheng Wan Yuan-Lu Chen Huan-Long Li Shan-Shan Wang Ze-Fu Chen 

机构地区：[1]Department of Pulmonary and Critical Care Medicine,Kunming Children’s Hospital,Yunnan Key Laboratory of Children’s Major Disease Research,Kunming 650034,Yunnan Province,China [2]Department of Pediatrics,Hainan General Hospital,Haikou 570311,Hainan Province,China

出　　处：《World Journal of Clinical Cases》2023年第30期7372-7379,共8页世界临床病例杂志

摘　　要：BACKGROUND Burkholderia pseudomallei(B.pseudomallei)is a short,straight,medium-sized Gramnegative bacterium that mostly exists alone,without a capsule or spores,has more than three flagella at one end,and actively moves.B.pseudomallei confers high morbidity and mortality,with frequent granulocytopenia in B.pseudomallei sepsisrelated deaths.However,mortality may be related to hemophagocytic lymphohistiocytosis(HLH)secondary to B.pseudomallei infection.CASE SUMMARY A 12-year-old female was referred from a local hospital to the pediatric intensive care unit with suspected septic shock and fever,cough,dyspnea,and malaise.After admission,supportive symptomatic treatments including fluid resuscitation,anti-infective therapy,mechanical ventilation,and a vasoactive drug maintenance cycle were carefully initiated.The patient became unconscious,her blood pressure could not be maintained even under the exposure of vasoactive drugs,and she experienced cardiorespiratory arrest.The patient died due to ineffective high-quality in-hospital cardiopulmonary resuscitation.A subsequent bone marrow smear examination revealed extensive phagocytosis,and the blood culture was positive for B.pseudomallei.Family history revealed a sibling death from B.pseudomallei sepsis 5 years earlier.CONCLUSION The higher mortality rate in patients with B.pseudomallei sepsis may be related to secondary HLH after infection,wherein multiorgan dysfunction syndrome may be directly related to infection or immune damage caused by secondary HLH.Patients with B.pseudomallei can be asymptomatic and can become an infective source.

关 键 词：Burkholderia pseudomallei SEPSIS Septic shock Hemophagocytic lymphohistiocytosis Asymptomatic carrier Case report 

分 类 号：R589.7[医药卫生—内分泌] R552[医药卫生—内科学]