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2019, Number 1

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Enf Infec Microbiol 2019; 39 (1)

Hemophagocytic lymphohistiocytic syndrome secondary to urinary tract infection due to Escherichia coli, case report

Reyes HKL, Santos-Calderón LA, Reyes GU, Quero HA, López CG, Reyes HDP, Guerrero BM, Matos ALJ, Reyes BM, López TNL, Cuevas LL

Language: Spanish
References: 39
Page: 36-42
PDF size: 436.03 Kb.


ABSTRACT

Introduction. hemophagocytic lymphohistiocytic syndrome (LHL) is a rare entity in pediatrics, is characterized by a dysfunction in the cytotoxic activity of nk cells and CD8+ T lymphocytes, which causes an excessive and persistent activation of histociocytes-macrophages and T lymphocytes, which is followed by hemophagocytosis. In its secondary form it is associated with neoplastic, immunological and infectious processes. In the latter, cases have been reported triggered by viruses, parasites and bacteria.
Clinical case. A 6-year-old female schoolchild, with a history of two previous urinary tract infections, starts again as a febrile syndrome secondary to a urinary infection due to Escherichia coli. Within the study protocol, she presents six of the eight criteria necessary for establish the diagnosis of LHL: fever, splenomegaly, bicitopenia (neutropenia and anemia), hypertriglyceridemia, increased serum ferritin and hemophagocytosis in bone marrow. Treatment was carried out with a double scheme of antibiotics and steroid in reduction scheme, its clinical evolution was to improvement.
Conclusion. Cases of LHL secondary to enterobacterial infection will increase, especially due to the increasingly frequent occurrence of E. coli infections with an extended spectrum of high antimicrobial resistance, which presents unusual clinical pictures and is not very concordant with clinical and laboratory


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