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Complicações infeciosas num doente com anemia aplástica : caso clínico
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A Anemia Aplástica é uma doença relativamente rara, caracterizada por pancitopenia e hipocelularidade da medula óssea, apresentando o maior pico de incidência na segunda década de vida. A forma inicial mais comum de apresentação da doença revela sinais e sintomas de anemia ou trombocitopenia. A neutropenia e as complicações infeciosas derivadas da mesma, representam atualmente a principal causa de mortalidade nestes doentes. Neste trabalho descreve-se o caso de um jovem com 14 anos, do sexo masculino, que é evacuado do país de origem para efetuar tratamento em Portugal. Apresentava um quadro inicial de fadiga e laboratorialmente evidenciava pancitopenia, com neutropenia de 60/mm3, sendo classificada como Anemia Aplástica muito grave. Em consequência da marcada neutropenia surgiram complicações: uma infeção aguda a Parvovírus B19 e infeções por Aspergillus fumigatus, Klebsiella pneumoniae e Enterobacter asburiae. Foi realizado transplante de células hematopoiéticas progenitoras alogénico de irmão, dador compatível. Tendo por base este caso clinico discutem-se as complicações infeciosas em doentes com Anemia Aplástica.
Aplastic Anemia is a relatively rare disease characterized by pancytopenia and bone marrow hypocellularity, which has the highest incidence peak in the second decade of life. Classically, patients inicially show signs and symptons of anemia or thrombocytopenia. The leading cause of mortality is due to neutropenia and infectious complications. We report the case of a 14-year-old male with an initial presentation of fatigue, who is evacuated from the country of origin for treatment in Portugal. The laboratory analyses revealed pancytopenia, with neutropenia of 60/mm3, being classified as very severe Aplastic Anemia. Acute infection with Parvovirus B19 was also present. Due to the marked neutropenia, infections by Aspergillus fumigatus, Klebsiella pneumoniae and Enterobacter asburiae were developed. Hematopoietic stem cell allogeneic transplantation from a compatible brother was performed. Using this case as a base, we discuss the infectious complications in patients with Aplastic Anemia.
Aplastic Anemia is a relatively rare disease characterized by pancytopenia and bone marrow hypocellularity, which has the highest incidence peak in the second decade of life. Classically, patients inicially show signs and symptons of anemia or thrombocytopenia. The leading cause of mortality is due to neutropenia and infectious complications. We report the case of a 14-year-old male with an initial presentation of fatigue, who is evacuated from the country of origin for treatment in Portugal. The laboratory analyses revealed pancytopenia, with neutropenia of 60/mm3, being classified as very severe Aplastic Anemia. Acute infection with Parvovirus B19 was also present. Due to the marked neutropenia, infections by Aspergillus fumigatus, Klebsiella pneumoniae and Enterobacter asburiae were developed. Hematopoietic stem cell allogeneic transplantation from a compatible brother was performed. Using this case as a base, we discuss the infectious complications in patients with Aplastic Anemia.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Anemia aplástica Neutropenia Aspergillus Pediatria