Atypical clinical course of pneumonia in a patient with ummunodeficiency, iron-deficient anemia and dietary supplement intake

Abstract

A clinical case pneumonia and multiple organ dysfunction syndrome in a patient with iron-deficiency anemia and previous intake of a dietary supplement for weight loss is presented, including results of examinations, observation and treatment. A 22 years old female was admitted with complaints on dyspnea, dry cough, malaise, «pulsing» head ache at the back of the head, vertigo while walking, fever up to 39 °С during the previous 3 days. Basing on the results of chest X-ray and laboratory examination the diagnosis of «Community-acquired subtotal right-sided pneumonia of mixed origin, severe clinical course, respiratory failure grade III, complicated by toxic shock syndrome, toxic pulmonary edema, disseminated intravascular coagulopathy stage I. Acute cardiac failure, acute respiratory distress syndrome. Acute iron-deficiency anemia. Acute erosive hemorrhagic gastritis. Obesity, II degree» was set up. In spite of active treatment patient’s condition deteriorated due to intoxication, cardiac failure and respiratory distress progress. Autopsy revealed that the patient has died of severe viral pneumonia, although such an extensive pneumonia is not typical for a 22-year old patient. Severe pneumonia development may be explained by immunodeficiency intensified by acute iron-deficiency anemia, which can be a possible side effect of previous intake of a dietary supplement for weight loss and alimentary factors.