[Hemophagocytic syndrome associated with tuberculosis in a patient with acquired immunodeficiency].
The secondary hemophagocytic syndrome is rare in children and even rarer associated with tuberculosis. e report the case of a patient with acquired immunodeficiency syndrome, disseminated tuberculosis and hemophagocytic syndrome. An 8-year-old girl, diagnosed with acquired immunodeficiency syndrome, was admitted due to fever, vomiting and abdominal pain. She presented abdominal distension, dehydration, tachypnea, crackles and wheezing in both lungs, anemia, thrombocytopenia and coagulopathy. She received broad-spectrum antibiotics and exploratory laparotomy was performed with appendectomy and lymph node biopsy. After 72 hours the patient presented tonic clonic seizure, impaired sensory, fever, hypoxemia, hepatosplenomegaly, ascites and peripheral edema. She developed bicytopenia, hyperferritinemia and bone marrow microscopic examination with hemophagocytosis. She received intravenous gammaglobulin, steroids and blood transfusions. Mycobacterium tuberculosis was cultured in gastric aspirate, bone marrow and abdominal lymph node biopsy. She was treated with isoniazid, rifampicin, streptomycin and ethambutol, showing marked improvement.
División Neumotisiología, Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina. negonza@intramed.net.
Norma E
NE
González
División Neumotisiología, Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina.
Silvia
S
Álvarez Ponte
División Neumotisiología, Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina.
Mariela
M
López
División Neumotisiología, Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina.
Pablo
P
Fronti
División Neumotisiología, Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina.
Silvina
S
Smith
División Neumotisiología, Hospital General de Niños "Pedro de Elizalde", Ciudad Autónoma de Buenos Aires, Argentina.
Victor
V
Pawluk
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology*; D014376:Tuberculosis / Q000150:complications*
HIV; Hemophagocytic syndrome; Tuberculosis