HEMOPHAGOCYTOSIS SECONDARY TO PHARYNGEAL ABSCESS IN AN IMMUNOCOMPETENT PATIENT (case report)

Background. Hemophagocytosis is a rare, potentially fatal disorder, comprising pancytopenia, liver dysfunction, hepatosplenomegaly, hypertriglyceridemia, and hyperferritinemia presenting as fever, lympha­denopathy and skin rashes. Objective. To attract the clinicians’ attention to a problem of hemophagocytosis in Critical Care management.Methods. Hemophagocytosis secondary to pharyngeal abscess in a 58 year old male is being reported.Results. A 58-year-old immunocompetent patient presenting with hemophagocytosis secondary to pharyngeal abscess, was managed on ventilator and inotropic support, when he developed heathcare-associated urinary tract infection by Escherichia coli and ventilator-associated pneumonia by Acinetobacter baumanii. He developed neutropenic septic shock and multi-organ dysfunction and went through a downhill course leading to demise.Conclusions. Hemophagocytosis remains a sinister entity in modern intensive care despite astute clinical management. Secondary superinfections with opportunistic multidrug resistant pathogens are difficult to treat. A high index of clinical suspicion, aggressive diagnosis and prompt treatment for hemophagocytosis and polymicrobial opportunistic superinfections with multidrug-resistant healthcare-associated pathogens needs to be addressed upfront.