A 43-year-old man who suffered from phlegmone was admitted to our hospital. The peripheral blood showed anemia, thrombocytopenia and leukocytosis; almost all the white cells were hypersegmented neutrophils. A bone marrow aspirate was a hypocellular material and blast cells increased to 4%. A bone marrow biopsy specimen was hypercellular and morphological adnormalities were detected in megakaryocytes. A diagnosis of refractory anemia was made.
CRP was storongly positive. An administration of antibiotics and γ-globulin for phlegmone was not effective on the high fever. Neutrophil function tests revealed normal phagocytic activity and chemotaxis, but inadequate bactericidal activity. Granulocyte transfusions were given for 5 days. 2 days after the last transfusion, high fever ran down and CRP was negative. Phlegmone subsided gradually.
He showed leukocytosis, mainly consisting of adnormal neutrophils, during phlegmone. As the cause of phlegmone, inadequate bactericidal activity and adnormal differentiated clone of myeloid by bacterial infection were suggested.
