The Conundrum of Septic Shock Imitators in Patients with Hematologic Cancers: Case Presentation and Possible Differential Diagnoses

Table 5

Possible differential diagnoses of fulminant MODS.

Diagnosis	Pro	Against	Likelihood
Septic shock	(1) Immusuppression	(1) Fulminant time course of MODS	H
	(2) Blood culture positive for E. coli	(2) Not responding to standard anti-SS treatment
Rituximab-induced cytokine release syndrome	(1) Clinical picture resembling SIRS	(1) Interval >24 h between treatment and onset of symptoms	L
Acquired hemophagocytic lymphohistiocytosis	(1) NHL	none	H
	(2) Recent CMV infection
	(3) 5/8 preliminary diagnostic criteria fulfilled
	(4) Elevated HScore
Catastrophic anti phospholipid syndrome	(1) Recent NHL	(1) Diagnostic criteria unfulfilled	L
Acute adrenal failure	(1) Failed response to volume resuscitation and vasopressors	(1) No hyponatremia	H
	(2) Autopsy findings

H: high; L: low; I: intermediate.