Hyperferritinemic sepsis secondary to invasive Toxoplasma gondii in a child with untreated HIV

Jesús Domínguez-Rojas, Jackeline Caute-Lara, Patrick Caqui-Vilca, Mario Cruz-Arpi, Carlos Martel-Ramírez, Miguel Quispe-Chipana, Abel Sánchez-Rodríguez, Noé Atamari-Anahui

Untreated human immunodeficiency virus (HIV)-immunosuppressed pediatric patients show high morbidity and mortality from opportunistic infections. Limited cases of hyperferritinemic sepsis have been described in patients with toxoplasmosis. We describe the case of a 13-year-old female patient with a history of untreated HIV who presented with hyperferritinemic sepsis secondary to Toxoplasma gondii infection and Pneumocystis jirovecci pneumonia. She received ventilatory support, inotropic drugs, treatment for opportunistic germs, and high-dose corticosteroids, but with unfavorable evolution. The global approach to sepsis with elevated ferritin guides to using of therapies aimed at neutralizing the severe inflammatory response. A timely diagnosis would allow prompt treatment and minimize complications.