[Acute neutropenia in adult severe bacterial infections. Six cases (author's transl)]

Abstract

A transient neutropenia (duration : less than 48 hours) occurred in 6 patients with severe bacterial infections. The bone marrow myeloïd cellularity was high or normal; a maturation arrest of the myeloïd cells - at a variable stage - was present in each case, as well as circulating granulocyte precursors. Other causes of neutropenia were excluded. A general survey of the literature is made and the mechanisms of this bacterial neutropenia are considered : bone marrow failure seems mostly improbable ; the few previously reported cases, the experimental bacterial neutropenias, the peculiar, transient, evolution we observed, all favor a peripheral mechanism ; the bacterial infection seems to act by; two ways : in septicemia (especially during septic shock) by enhancing leucocyte margination along vascular walls ; in large septic foci (mostly pulmonary) by an important destruction of polymorphonuclear neutrophils. Such bacterial infections share a bad prognosis but the neutropenia itself needs no specific treatment.