急性髓单核细胞白血病表现为福尼尔坏疽

Sofie Kjellesvig, Emelyn Zaworski, Antoine N Saliba
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引用次数: 0

摘要

导言急性髓单核细胞白血病是一种单核细胞扩增的急性髓系白血病。急性髓单核细胞白血病及其治疗均可导致免疫力下降。免疫力低下的患者更容易受到感染,如福尼尔坏疽,这是一种罕见的腹股沟坏死性感染:一名 56 岁的男性因腹痛、白细胞增多和会阴部瘀斑到急诊科就诊。一夜之间,他的会阴部变色和疼痛加剧。他接受了冲洗和清创术治疗 Fournier 坏疽,并接受了广谱抗菌治疗。随后的检查发现他患有急性髓性白血病,并伴有切口白血病和中枢神经系统受累,因此必须在伤口完全愈合前开始化疗:本病例凸显了在并发危及生命的软组织感染的情况下诊断和治疗急性白血病所面临的挑战,因为血液病及其治疗都会加重感染并发症。
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Acute Myelomonocytic Leukemia Presenting as Fournier's Gangrene.

Introduction: Acute myelomonocytic leukemia is a type of acute myeloid leukemia with monocytic expansion. Both the disease and its treatment can be immunocompromising. Immunocompromised patients are more susceptible to infections, such as Fournier's gangrene, a rare necrotizing infection of the groin.

Case presentation: A 56-year-old male presented to the emergency department with abdominal pain, leukocytosis, and perineal ecchymosis. Overnight, his perineal discoloration and tenderness worsened. He underwent irrigation and debridement for Fournier's gangrene and received broad-spectrum antimicrobial therapy. Subsequent workup revealed acute myeloid leukemia with leukemia cutis and central nervous system involvement, necessitating chemotherapy initiation prior to complete wound healing.

Discussion/conclusions: This case highlights the challenges in the diagnosis and management of acute leukemia in the setting of a concomitant life-threatening soft tissue infection, as both the hematologic disease and treatment thereof can exacerbate infectious complications.

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