Université de Paris, AP-HP, hôpital Louis Mourier, DMU ESPRIT, médecine intensive réanimation, 92700 Colombes, France.
Université de Paris, AP-HP, hôpital Louis Mourier, DMU DREAM, department of radiology, 92700 Colombes, France.
Rev Med Interne. 2022 Oct;43(10):622-625. doi: 10.1016/j.revmed.2022.07.016. Epub 2022 Sep 8.
Hemophagocytic syndrome is a rare life-threatening disorder that can be triggered by various conditions such as HIV infection and opportunistic agents. We report a case of disseminated toxoplasmosis complicated with severe hemophagocytic syndrome and revealing an unknown acquired immunodeficiency syndrome. The patient presented with multiple organ failure in intensive care unit. Once diagnosed, he benefitted from etoposide infusion, administration of specific anti-toxoplasmosis treatments and secondary antiretroviral therapy. He was alive at intensive care unit discharge and returned home with little sequalae. This case illustrates both the importance of rapid investigations of hemophagocytic syndrome etiologies in HIV positive patients and the necessity to prompt etoposide and specific treatments in order to improve potentially dramatic outcomes.
噬血细胞综合征是一种罕见的危及生命的疾病，可由 HIV 感染和机会性病原体等多种情况引发。我们报告了一例播散性弓形虫病并发严重噬血细胞综合征并表现出未知获得性免疫缺陷综合征的病例。患者在重症监护病房出现多器官功能衰竭。一旦确诊，他受益于依托泊苷输注、特定抗弓形虫病治疗和继发抗逆转录病毒治疗。他在重症监护病房出院时仍存活，出院后几乎没有留下后遗症。该病例既说明了在 HIV 阳性患者中快速调查噬血细胞综合征病因的重要性，也说明了及时使用依托泊苷和特定治疗以改善潜在严重结局的必要性。
