Infect-associated hemophagocytosis, a rare cause of fatal pancytopenia

Case Report: We present the case of a feverish 36-year-old female patient w ith unspecific pain and weight loss. After initial diagnosis of an unclear infection with Candida esophagitis, unspecific duodenitis, proctitis and li ver damage there was a further clinical deterioration during antibiotic and symptomatic therapy. A newly developed pancytopenia could be identified as caused by reactive hemophagocytosis using bone marrow analysis. The patien t died despite maximal supportive and specific therapy. Cause of death was a retroperitoneal hematoma and an invasive aspergillosis, the latter not id entified premortem. Conclusion: The reactive infect-associated hemophagocytosis is a rare diffe rential diagnosis in feverish pancytopenia. The prognosis is poor. In absen ce of a pr-oven causal therapy supportive therapy and maximal diagnostics f or detection of curable underlying diseases are essential. Antimycotic ther apy should be considered generally.