Klebsiella pneumoniae associated extreme plasmacytosis

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Infection-associated plasmacytosis is common, but marked plasmacytosis mimicking plasma cell leukemia is rare.
• Aplastic anemia patients are susceptible to severe infections.
• Klebsiella pneumoniae sepsis can present with unusual hematological findings.

Purpose of the Study:

• To report a rare case of extreme plasmacytosis in an aplastic anemia patient with Klebsiella pneumoniae sepsis.
• To highlight the diagnostic challenges and reactive nature of severe plasmacytosis in this context.
• To emphasize the importance of identifying underlying causes for marked plasmacytosis.

Main Methods:

• Case report of a 42-year-old male with aplastic anemia and sepsis.
• Hematological analysis including peripheral blood counts and bone marrow biopsy/aspiration.
• Identification of Klebsiella pneumoniae via blood and sputum cultures.
• Monitoring of plasma cell proportion and bone marrow cellularity over 90 days.

Main Results:

• The patient presented with severe neutropenia, thrombocytopenia, and marked plasmacytosis (80% in bone marrow), mimicking plasma cell leukemia.
• Klebsiella pneumoniae sepsis was identified and treated, leading to improvement in fever but worsening hematological parameters.
• Plasmacytosis progressively decreased, confirming its reactive nature (polyclonality).

Conclusions:

• This is the first reported case of marked plasmacytosis associated with Klebsiella pneumoniae sepsis in an aplastic anemia patient.
• Severe reactive plasmacytosis can mimic plasma cell leukemia, necessitating thorough investigation for underlying infections.
• Prompt identification and management of sepsis are crucial in immunocompromised patients with atypical hematological findings.