Pseudomonas aeruginosa Infection Presenting as Microangiopathic Hemolytic Anemia and Thrombocytopenia

Area of Science:

• Infectious Diseases
• Hematology
• Microbiology

Background:

• Congenital human immunodeficiency virus (HIV) infection can predispose individuals to opportunistic infections.
• Microangiopathic hemolytic anemia and thrombocytopenia are serious hematological conditions that can be caused by various factors.

Observation:

• A 28-year-old female with congenital HIV presented with symptoms mimicking thrombotic thrombocytopenic purpura (TTP).
• Her condition was found to be secondary to a multi-drug resistant Pseudomonas aeruginosa pulmonary infection.
• Normal ADAMTS13 activity ruled out TTP, indicating an alternative diagnosis.

Findings:

• Pseudomonas aeruginosa infections, particularly multi-drug resistant strains, can present with clinical features similar to TTP, including microangiopathic hemolytic anemia and thrombocytopenia.
• Antibiotic resistance can develop during treatment, underscoring the need for careful monitoring and appropriate antimicrobial strategies.

Implications:

• This case emphasizes the importance of considering infectious etiologies in patients presenting with TTP-like symptoms.
• Adherence to guidelines for dual antibiotic coverage for Pseudomonas aeruginosa infections is critical to prevent the development of antibiotic resistance.
• Early and accurate diagnosis is essential for effective management and improved patient outcomes in complex cases involving HIV and resistant infections.