Perspective
Ann Hematol Oncol. 2020; 7(9): 1319.
Septic Arthritis in a Patient with Acute Myeloid Leukemia
Dennis C. Harrer1*, Florian Lüke3 and Daniel Heudobler2
1Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Germany
2Bavarian Center for Cancer Research, Regensburg, Germany
3Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Germany
*Corresponding author: Dennis C. Harrer, Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Franz-Josef- Strauß-Allee 11, DE-93053 Regensburg, Germany
Received: November 03, 2020; Accepted: December 03, 2020; Published: December 10, 2020
Clinical Image
A 65-year-old man who had been newly diagnosed with Acute Myeloid Leukemia (AML) presented to the department of hematology with a painful swelling of his right knee. At presentation the patient was afebrile and physical examination revealed a swollen and overheated right knee. Blood analysis showed pancytopenia with grade four neutropenia and elevation of C-reactive protein. Moreover, myeloid blasts (Panel A◄) and hypolobated neutrophils (Pelger- Huët neutrophils) with reduced or missing granulation (Panel B*) could be detected in the peripheral blood. X-ray-imaging of the right knee did only show early-stage arthrotic changes. On the suspicion of septic arthritis in the context of AML-induced immunosuppression the knee was punctured and 50 milliliters of turbid fluid was drained. The synovial fluid leukocyte count was 24400 per mm3. Microscopic examination showed an abundance of (dysplastic) neutrophils (*) with myeloid blasts (◄) interspersed in between (Panel C+D). Having confirmed the diagnosis of septic arthritis the patient was hospitalized and intravenous antibiotics were started (Figure 1).
Figure 1:
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