School of Medicine, Universidad de los Andes, Bogotá, Colombia.
Universidad El Bosque, Bogotá, Colombia
BMJ Case Rep. 2023 Sep 21;16(9):e255226. doi: 10.1136/bcr-2023-255226.
A female patient in her 30s presented to the emergency department with a 10-day history of fever, weakness and diaphoresis. Subsequent investigations revealed a diagnosis of haemophagocytic syndrome, secondary to disseminated non-tuberculous mycobacterial infection affecting the bone marrow, lungs, lymph nodes and skin. The bone marrow culture confirmed the presence of infection. The patient's haemophagocytic syndrome was managed using the HLH-2004 chemoimmunotherapy, and infection was treated with a combination of clarithromycin, ethambutol, rifampicin, ciprofloxacin and amikacin. Throughout her hospitalisation, the patient faced several serious complications arising from both the medications and the prolonged hospital stay (lasting 12 months). However, these complications were promptly identified and effectively managed through a multidisciplinary and comprehensive approach. This approach was crucial in achieving a favourable patient outcome and successful recovery.
一位 30 多岁的女性患者因发热、乏力和出汗 10 天到急诊科就诊。进一步检查显示，患者患有噬血细胞综合征，继发于骨髓、肺、淋巴结和皮肤播散性非结核分枝杆菌感染。骨髓培养证实存在感染。患者的噬血细胞综合征采用 HLH-2004 化疗免疫疗法进行治疗，感染采用克拉霉素、乙胺丁醇、利福平、环丙沙星和阿米卡星联合治疗。在整个住院期间，患者因药物和长时间住院（持续 12 个月）而面临多种严重并发症。然而，通过多学科和综合方法，及时发现并有效管理了这些并发症。这种方法对于实现有利的患者预后和成功康复至关重要。
