Fatal hemophagocytic lymphohistiocytosis-induced multiorgan dysfunction secondary to Burkholderia pseudomallei sepsis: A case report

Table 1 Laboratory data of the patient’s brother

Variable	Reference range	Initial value
Routine blood examination
White cell count as × 109/L	4.30-11.30	0.60
Neutrophil count as × 109/L	1.60-7.80	0.40
Hemoglobin in g/L	118-156	104
Platelet count as × 109/L	150-407	184
Inflammatory indicators
C-reactive protein in mg/L	0-8.00	200.00
Procalcitonin in ng/mL	0-0.046	98.670
Erythrocyte sedimentation rate in mm/h	0-15	33
Arterial blood gas analysis
pH	7.350-7.450	7.076
PaO2 in mmHg	83.0-108.0	43.4
PaCO2 in mmHg	35-45	37
HCO3- in mmol/L	22.0-27.0	12.5
BE in mmol/	-3.0 to 3.0	-19.0
Lactic acid in mmol/L	0.5-1.7	13.1
Coagulative function
Prothrombin time in s	9.8-13.2	21.1
International normalized ratio	0.85-1.20	1.64
D-dimer in ng/mL	0-0.50	4209.00
Biochemical examination
Glutamic pyruvic transaminase in U/L	7-30	43
Albumin in g/L	39.0-54.0	27.4
Total bilirubin in µmol/L	0-21.0	27.2
Direct bilirubin in µmol/L	0-8.0	20.1
Urea nitrogen in mmol/L	2.5-6.5	8.8

BE: Base excess.

Table 2 Laboratory data of the patient

Variable	Reference range	Initial value	Value retested after 4 h	Last value before death
Routine blood examination
White cell count as × 109/L	4.30-11.30	0.69	0.83	-
Neutrophil count as × 109/L	1.60-7.80	0.08	0.08	-
Hemoglobin in g/L	118-156	112	83	-
Platelet count as × 109/L	150-407	50	23	-
Inflammatory indicators
C-reactive protein in mg/L	0-8.00	239.04	135.83	-
Procalcitonin in ng/mL	0-0.046	73.540	-	-
Erythrocyte sedimentation rate in mm/h	0-20	8	-	-
Ferritin in ng/mL	4.63-204.00	14586.00	-	-
Arterial blood gas analysis
pH	7.350-7.450	7.150	7.230	6.840
PaO2 in mmHg	83.0-108.0	69.0	73.0	22.0
PaCO2 in mmHg	35-45	28	28	88
BE in mmol/L	-3.0 to 3.0	-17.6	-14.5	-19.2
Oxygenation index	-	191	202	36
Lactic acid in mmol/L	0.5-1.7	15.8	14.5	16.7
Coagulation function
Prothrombin time in s	9.8-13.2	22.9	53.6	-
International normalized ratio	0.85-1.20	1.97	5.99	-
Thrombin time in s	14.0-21.0	14.7	240.0	-
Activated partial thromboplastin time in s	28.0-43.0	58.1	180.0	-
Fibrinogen in g/L	2.00-4	-	1.56	-
D-dimer in ng/mL	0-0.50	24.93	11.43	-
Biochemical examination
Glutamic pyruvic transaminase in U/L	7.0-30.0	101.4	192.6	-
Albumin in g/L	39.0-54.0	27.3	19.7	-
Total bilirubin in µmol/L	0-21.00	89.07	54.83	-
Direct bilirubin in µmol/L	0-8.00	51.46	31.99	-
Indirect bilirubin in µmol/L	0-21.00	37.61	22.84	-
Urea nitrogen in µmol/L	2.50-6.50	10.75	11.02	-
Creatinine in µmol/L	27-66	157	82	-
K+ in mmol/L	3.50-5.50	3.41	2.65	-
Na+ in mmol/L	130.0-150.0	135.9	142.6	-
Ca2+ in mmol/L	2.10-2.80	1.76	1.45	-
Triglyceride in mmol/L	0-1.70	1.57	-	-
Cytokines in pg/mL
Interleukin-1B	0-12.40	623.47	-	-
Interleukin-6	0-5.30	1452.90	-	-
Interleukin-8	0-53.09	1876.33	-	-
Interleukin-10	0-4.91	5754.38	-	-
Interferon-γ	0-7.42	3143.99	-	-
Tumor necrosis factor	0-4.60	42.28	-	-

BE: Base excess.