Keita Maxime, Kamara Ismael, Atiméré Yao Nicaise, Koné Daouda and Tolo Diebkilé Aissata
Summary Context: Macrophage activation syndrome and bone marrow necrosis are all extremely rare phenomena that can each be secondary to pathologies including neoplastic, infectious or even congenital. These conditions are most often discovered late and in conditions where the patient›s vital prognosis is at stake, making their management difficult. The association of these two conditions is an extremely rare phenomenon and little described by the authors. We describe a
simultaneous discovery of bone marrow necrosis and macrophage activation syndrome in a patient received for treatment of febrile pancytopenia.
Presentation of Cases: 37-year-old patient hospitalized for exploration and management of subacute febrile pancytopenia in whom the diagnosis of bone marrow necrosis was made on the basis of bone marrow cytology and activation syndrome macrophage according to the HLH 2004 and H-score criteria. The etiological investigations carried out in this direction made it possible to find immunosuppression (HIV1+) complicated by opportunistic infection (Mycobacterium Tuberculosis).
Conclusion: From this work, we show the complexity linked to the management of such a diagnostic association (marrow necrosis and macrophage activation syndrome) occurring in conditions of immunosuppression with opportunistic coinfection.