背景:噬血细胞淋巴组织细胞增多症(HLH)是一种严重的疾病,其特征是免疫系统过度激活,导致高细胞因子血症和多器官损伤。我们报告了一例由弯曲杆菌感染引起的HLH伴心肌心包炎的罕见病例。
方法:一名28岁的男性患者,有高血压病史,没有药物控制,发烧四天后在医院就诊,减少尿量,他的躯干和四肢上有皮疹,和其他症状。他被临时诊断为非典型感染和与双氯芬酸有关的过敏性皮疹。然而,他的病情恶化,他感到震惊,心动过速,胸部窘迫,入院后双侧胸腔积液。进一步的调查显示心源性休克与心肌心包炎有关,他被转移到重症监护室.此外,粪便PCR小组随后显示弯曲杆菌阳性结果.在第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,贫血和血小板减少伴心源性休克状态改善。然后,他后来出院,情况稳定。
结论:由弯曲杆菌引起的HLH和心肌心包炎非常罕见。早期发现弯曲杆菌诱导的HLH和多器官衰竭,以及迅速使用抗生素和免疫抑制剂,有助于预后。
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.
METHODS: 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.