What infections can cause pancytopenia (a condition characterized by a reduction in the number of red blood cells, white blood cells, and platelets)?

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From the FDA Drug Label

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From the Research

Pancytopenia can be caused by various infections, including viral, bacterial, parasitic, and fungal infections, with the most recent study suggesting that infections are the leading etiology, accounting for 17.9% of cases, with enteric fever being the most frequently observed cause 1.

Infections Causing Pancytopenia

The following infections can cause pancytopenia:

  • Viral infections: HIV, hepatitis B and C, Epstein-Barr virus, cytomegalovirus, and parvovirus B19, as well as SARS-CoV-2 infection, which has been reported to cause pancytopenia in rare cases 2
  • Bacterial infections: tuberculosis, typhoid fever, brucellosis, and overwhelming sepsis, with brucellosis being a significant cause, particularly in endemic regions 3
  • Parasitic infections: malaria, leishmaniasis, and visceral leishmaniasis (kala-azar), which can directly infiltrate the bone marrow
  • Fungal infections: histoplasmosis and cryptococcosis, which can result in pancytopenia, especially in immunocompromised individuals

Mechanisms of Pancytopenia

These infections cause pancytopenia through various mechanisms, including:

  • Direct bone marrow invasion
  • Immune-mediated destruction of blood cells
  • Hemophagocytosis
  • Triggering disseminated intravascular coagulation

Treatment

Treatment should target the underlying infection with appropriate antimicrobials, while providing supportive care for cytopenias, and early diagnosis and treatment can reverse pancytopenia and prevent over-investigation 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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