Necrotizing Laryngitis in Patients with Hematologic Disease: The First Case-Report Due to PDR Acinetobacter baumannii and Literature Review

TL;DR

A patient with multiple myeloma developed a rare and severe throat infection caused by Acinetobacter baumannii, highlighting the need for prompt diagnosis and specialized care.

Contribution

This is the first reported case of necrotizing laryngitis in hematologic disease patients caused by PDR Acinetobacter baumannii.

Findings

Necrotizing laryngitis in hematologic disease patients can be caused by PDR Acinetobacter baumannii.

Prompt laryngoscopy and tissue culture are critical for diagnosis and management.

Specialized care and high clinical suspicion are essential for treating this condition.

Abstract

Immunocompromised patients with hematologic diseases may experience life-threatening infections with rather uncommon manifestations. Laryngitis has been described as a potential infection in such vulnerable patients and may result in major complications, ranging from impending airway obstruction to total laryngeal necrosis. Immediate laryngoscopy is of paramount importance, as it provides quantification of laryngeal edema and evidence of necrosis. Documentation of the causative pathogen is usually feasible through tissue culture. In the literature, 14 cases of necrotizing laryngitis have already been published. Here, we present the case of a 38-year-old male with a recent diagnosis of multiple myeloma, who received the first cycle of therapy a few days before admission. The patient presented with neutropenic fever, diarrhea, and multiple organ dysfunction. His course was complicated with hemophagocytic lymphohistiocytosis and stridor. A diagnosis of necrotizing laryngitis attributed to Acinetobacter baumannii invasion of the larynx was established. This manuscript highlights that the management of patients with hematologic disease and necrotizing laryngitis should be coordinated in highly specialized centers and clinicians should have a high level of clinical suspicion and act promptly.

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