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[Acute neutropenia in adult severe bacterial infections. Six cases (author's transl)]
Abstract:
A transient neutropenia (duration : less than 48 hours) occurred in 6 patients with severe bacterial infections. The bone marrow myeloïd cellularity was high or normal; a maturation arrest of the myeloïd cells - at a variable stage - was present in each case, as well as circulating granulocyte precursors. Other causes of neutropenia were excluded. A general survey of the literature is made and the mechanisms of this bacterial neutropenia are considered : bone marrow failure seems mostly improbable ; the few previously reported cases, the experimental bacterial neutropenias, the peculiar, transient, evolution we observed, all favor a peripheral mechanism ; the bacterial infection seems to act by; two ways : in septicemia (especially during septic shock) by enhancing leucocyte margination along vascular walls ; in large septic foci (mostly pulmonary) by an important destruction of polymorphonuclear neutrophils. Such bacterial infections share a bad prognosis but the neutropenia itself needs no specific treatment.
Insights
Severe bacterial infections can cause temporary neutropenia (low white blood cell count) in patients. This condition, characterized by myeloid cell maturation arrest, is likely due to peripheral mechanisms rather than bone marrow failure.
Area of Science:
- Hematology
- Infectious Diseases
- Pathophysiology
Context:
- Transient neutropenia observed in patients with severe bacterial infections.
- Exclusion of other potential causes for neutropenia.
- High or normal bone marrow myeloid cellularity noted.
Purpose:
- To investigate the mechanisms behind transient neutropenia in severe bacterial infections.
- To differentiate between peripheral and bone marrow failure as causes.
- To review literature and experimental data on bacterial neutropenia.
Summary:
- Six patients with severe bacterial infections experienced transient neutropenia (<48 hours).
- A maturation arrest of myeloid cells and circulating granulocyte precursors were observed.
- Mechanisms favor peripheral causes, including leukocyte margination in septicemia and polymorphonuclear neutrophil destruction in septic foci.
Impact:
- Suggests bacterial infections trigger neutropenia via peripheral mechanisms.
- Highlights the role of leukocyte margination and neutrophil destruction.
- Indicates neutropenia in this context requires no specific treatment, despite poor prognosis of the underlying infection.