A 72-year-old man with no relevant history was admitted for respiratory failure and fever with a diagnosis of pneumonia.
Cultures and serology for herpes and CMV were negative, as well as all serology as previous patients.
She received empirical antibiotic treatment.
Two weeks after admission the patient developed fever and worsening of the right basal radiological images.
LAB was performed and showed no bacterial growth.
The patient developed paulatinically cites Hb of the three series: 7 g/l; white blood cell count: 1,600/mm3; platelets: 49,000/mm3.
Ferritin was 4,000 μg/l, triglycerides 607 mg/dl, fibrinogen 111%.
PAMO showed an increase of macrophages in 10% with hemophagocytosis.
Physical examination revealed only mild hepatomegaly.
Methylprednisone was administered at a dose of 1 g/day for three days and gammaglobulin at doses of 400 mg/kg/day for 5 days.
The patient developed persistent fever and required mechanical ventilation.
Citations did not improve.
Cultures that were always negative were repeated, except for one LAB that showed significant growth of a multiresistant Acinetobacter baumannii that received treatment.
She died 44 days after admission with multiorgan failure.
