Camille Gorena, Borna Amir-Kabirian, Ju-Hsien Chao
Hyperleukocytosis (> 100 × 109/L) is typically associated with hematologic malignancies and is rarely reported in infection. A previously healthy 27-year-old man presented with acute gastrointestinal symptoms and was found to have meningococcal bacteremia complicated by thrombocytopenia, coagulopathy, and acute kidney injury. Despite appropriate antimicrobial therapy, his leukocyte count rose progressively, peaking at 173 × 109/L on hospital day four. Bone marrow biopsy and cytogenetic studies excluded leukemia. With continued antibiotic therapy and supportive care, his leukocyte count, coagulopathy, and renal function gradually normalized over the following 10 days. This case highlights hyperleukocytosis as a rare manifestation of meningococcemia and emphasizes the importance of excluding malignancy while managing infection-related complications.