Bacteria-associated hemophagocytic syndrome.

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Histiocytic medullary reticulosis (HMR) was historically defined as a neoplastic disorder.
• Some HMR cases present with systemic histiocyte proliferation, hemophagocytosis, bone marrow necrosis, pancytopenia, hepatitis, and coagulopathy.

Observation:

• Patients exhibit fever, constitutional symptoms, hepatosplenomegaly, and lymphadenopathy.
• While mortality is high, the condition appears reactive, often associated with active viral infections.
• This study describes three cases of hemophagocytic syndrome linked to bacterial sepsis, excluding viral causes.

Findings:

• The hemophagocytic syndrome can be triggered by bacterial sepsis.
• Active viral infections previously associated with the syndrome were ruled out in these cases.
• Disseminated infections, beyond viral, can precipitate the hemophagocytic syndrome.

Implications:

• The hemophagocytic syndrome may be a broader reactive process associated with diverse disseminated infections.
• Re-evaluating the etiology of HMR and similar syndromes is crucial.
• Understanding infectious triggers can guide diagnostic and therapeutic strategies for hemophagocytic syndromes.