A case report of death due to pulmonary infection-induced hemophagocytic syndrome
OBJECTIVE To analyze the clinical characteristics,diagnosis and treatment outcome of 1 case of pulmo-nary infection patient complicated with pericardial effusion so as to raise awareness of the critical disease hemoph-agocytic syndrome.METHODS A case of pulmonary infection complicated with pericardial effusion who were trea-ted in the Chinese PLA General Hospital was chosen as the research subject.The medical history,disease evolu-tion process,clinical laboratory tests and treatment reactions were summarized,the treatment strategies for unex-plained change of illness condition during the treatment process was explored so as to save time for the treatment.RESULTS The patient suffered from pulmonary infection complicated with pericardial effusion in the early onset and presented cardiac tamponade during the course of disease.Anti-infection therapy and pericardial puncture drainage were once effective,then the patient showed recurrent illness condition,rise of inflammatory indexes,rise of serum ferritin,anemia,decline of blood platelets,abnormal liver function,rise of triglyceride,decline of natural killer(NK)activity(12.34％)and rise of sCD25(32 843 pg/ml).Hemophagocytes were displayed on bone marrow smear,which conformed to 2004 criteria for diagnosis as hemophagocytic syndrome.CONCLUSION The infection may induce the overexpression of inflammation,especially in the patient with underlying rheumatic immune system diseases or blood system diseases.There is a phenomenon of separation of test result from clinical illness condition.It is necessary to detect the relatively specific indexes such as NK counts,CD4/CD8,sCD25,tri-glyceride and fibrinogen and carry out the bone marrow puncture and smear to find out the hemophagocytes in a timely manner if necessary so as to clarify the diagnosis,adjust the treatment direction and improve the prognosis of the patient.
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