2021 Volume 41 Issue 3 Pages 155-158
A 71-year-old male patient with a history of chronic myelomonocytic leukemia was transferred to our facility from a local hospital with a diagnosis of septic shock due to suspected acute cholecystitis. The patient underwent an urgent open cholecystectomy during which mild redness on the serosal surface of the ileum was observed, with no obvious necrosis. The patient remained hypotensive after the laparotomy, but his condition worsened, necessitating continuous infusion of adrenaline. The ileal lesion, previously identified during the cholecystectomy, was suspected as the cause of the septic shock and therefore resected. After the surgery, the patient’s circulatory status improved dramatically, and the adrenaline infusion was discontinued 12 hours later. Histopathology indicated infiltration of the leukemia cells into the intestinal wall. Bacterial translocation after massive ulceration due to leukemic infiltration was considered as the cause of the sustained hemodynamic instability. This case highlights how, in unusual cases, chronic myelomonocytic leukemia can present with septic shock.
