Leukoerythroblastosis in a Young Child with Severe Malaria and Superimposed Gram Negative Infection

J Trop Pediatr. 2018 Dec 1;64(6):553-556. doi: 10.1093/tropej/fmx101.

Abstract

Background: Leukoerythroblastosis, a non-specific and often short-lasting response of the bone marrow to different diseases such as malignancies or infections, is characterized by the presence in the peripheral blood of immature red and white cells.

Methods: We present a case of leukoerythoblastosis occurring in a 24 months old Mozambican girl, in the context of a severe malaria episode and an associated urinary tract infection. Peripheral blood smear was used for diagnosis of malaria and leukoerythroblastosis. Enterobacter cloacae isolation and antibiotic susceptibility testing were performed by conventional microbiology.

Results: Peripheral blood smear was positive for Plasmodium falciparum and showed a leukoerythroblastosis with red cell anisopoikilocytosis and left shifted neutrophils. Urine culture confirmed the presence of a multi-resistant E. cloacae. Treatment of underlying conditions resolved the leukoerythroblastic reaction.

Conclusions: Leukoerythroblastosis may be related to different infectious diseases and may also appear in the context of severe malaria. Bacterial superinfection needs to be investigated.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Myelophthisic / diagnosis*
  • Anemia, Myelophthisic / drug therapy
  • Anemia, Myelophthisic / microbiology
  • Antimalarials / therapeutic use
  • Blood Transfusion
  • Child, Preschool
  • Ciprofloxacin / therapeutic use
  • Enterobacter cloacae / isolation & purification*
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / drug therapy
  • Female
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Malaria, Falciparum / diagnosis*
  • Malaria, Falciparum / drug therapy
  • Plasmodium falciparum / isolation & purification*
  • Treatment Outcome
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / microbiology*

Substances

  • Antimalarials
  • Ciprofloxacin