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空肠弯曲菌引起的噬血细胞性淋巴组织细胞增生症和心肌炎:病例报告。

Hemophagocytic lymphohistiocytosis and myopericarditis induced by campylobacter: a case report.

机构信息

Department of Internal Medicine , Tungs' Taichung MetroHarbor Hospital, Taichung City, Taiwan.

Department of Infection, Tungs' Taichung MetroHarbor Hospital, No.699, Section 8, Taiwan Boulevard, Wuqi District, Taichung City, 43503, Taiwan.

出版信息

BMC Infect Dis. 2024 Apr 8;24(1):382. doi: 10.1186/s12879-024-09128-z.

Abstract

BACKGROUND

Hemophagocytic lymphohistiocytosis (HLH) is a severe disorder characterized by excessive activation of the immune system, leading to hypercytokinemia and damage to multiple organs. We report a rare case of HLH with myopericarditis caused by Campylobacter infection.

CASE PRESENTATION

A 28-year-old male patient with a history of hypertension without medicine control presented at the hospital after a four-day fever, decreasing urine amount, rashes on his trunk and limbs, and other symptoms. He was admitted with a provisional diagnosis of atypical infection and allergic skin rash related to diclofenac. However, his condition deteriorated, and he developed shock, tachycardia, chest distress, and bilateral pleural effusion after admission. Further investigations revealed cardiogenic shock related to myopericarditis, and he was transferred to the ICU. In addition, a stool PCR panel subsequently revealed a positive result for Campylobacter. On day 6, he was diagnosed with HLH. Under Clarithromycin and dexamethasone infusion, leukocytosis, anemia and thrombocytopenia with cardiogenic shock status improved. Then, he was later discharged in stable condition.

CONCLUSIONS

HLH and myopericarditis caused by Campylobacter are very rare. Early detection of Campylobacter-induced HLH and multiple organ failure, as well as prompt use of antibiotics and immunosuppressants, can be helpful for prognosis.

摘要

背景

噬血细胞性淋巴组织细胞增生症(HLH)是一种严重的疾病,其特征是免疫系统过度激活,导致细胞因子过度产生和多器官损伤。我们报告了一例由弯曲菌感染引起的伴有心肌心包炎的 HLH 罕见病例。

病例介绍

一名 28 岁男性患者,有高血压病史但未服用药物控制,因发热、尿量减少、躯干和四肢皮疹等症状持续四天后就诊。入院时初步诊断为与双氯芬酸相关的非典型感染和过敏性皮疹。然而,患者病情恶化,入院后出现休克、心动过速、胸痛和双侧胸腔积液。进一步检查发现与心肌心包炎相关的心源性休克,患者转入 ICU。此外,随后的粪便 PCR 面板检测出弯曲菌阳性结果。第 6 天,他被诊断为 HLH。在克拉霉素和地塞米松输注下,白细胞增多、贫血和血小板减少合并心源性休克状态得到改善。随后,患者情况稳定后出院。

结论

由弯曲菌引起的 HLH 和心肌心包炎非常罕见。早期发现弯曲菌引起的 HLH 和多器官衰竭,并及时使用抗生素和免疫抑制剂,有助于改善预后。

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