Extreme leukemoid reaction associated with retroperitoneal hemorrhage.
A respiratory tract infection in patients with C difficile colitis is an independent predictor of the presence of a leukemoid reaction.
Background: We sought to describe the characteristics of patients who had Clostridium difficile colitis complicated by leukemoid reactions (total leukocyte count greater than 35 X [10.
4) Leukemoid reactions are typically neutrophilic and may occur with various infections, malignancy, tissue necrosis, severe hemorrhage, hemolysis, and burns.
The two cases we describe were seen in association with C difficile infection, and we propose that severe infection with this organism should be particularly suspected if leukemoid reactions are observed in patients with AIDS who have signs and symptoms of colitis.
Leukemoid reactions have not previously been described in patients testing positive for the human immunodeficiency virus (HIV).
Leukemoid reactions in HIV-positive patients with signs of colitis may indicate severe C difficile infection.