Secondary hemophagocytic lymphohistiocytosis associated with Rocky Mountain spotted fever in a toddler: A case report.

Autor: Hosahalli Vasanna S; Department of Pediatric Hematology-Oncology Rainbow Babies and Children's Hospital/ University Hospitals Cleveland Ohio USA., Lim PPC; Department of Pediatric Infectious Diseases Rainbow Babies and Children's Hospital/University Hospitals Cleveland Ohio USA., Khan TS; Department of Pediatrics Rainbow Babies and Childreny's Hospital/University Hospitals Cleveland Ohio USA., Dalal J; Department of Pediatric Hematology-Oncology Rainbow Babies and Children's Hospital/ University Hospitals Cleveland Ohio USA.
Jazyk: angličtina
Zdroj: EJHaem [EJHaem] 2022 Apr 05; Vol. 3 (2), pp. 463-466. Date of Electronic Publication: 2022 Apr 05 (Print Publication: 2022).
DOI: 10.1002/jha2.405
Abstrakt: A three-year-old boy presented with fever, maculopapular rash involving palms and soles, and hyponatremia two weeks following a tick bite. Empiric doxycycline that he was on was discontinued following negative initial rickettsial serology based on the non-endemicity of Rocky Mountain spotted fever (RMSF) in Northeast Ohio. He demonstrated high inflammatory markers and met the criteria for hemophagocytic lymphohistiocytosis (HLH). With a working diagnosis of macrophage activation syndrome secondary to presumed systemic-onset juvenile idiopathic arthritis (soJIA), he received HLH-directed therapy. Rising antibody titers in convalescent sera established the diagnosis of RMSF. The patient recovered completely with HLH directed therapy and re-institution of doxycycline. This is the first pediatric case report of Rickettsia rickettsii induced HLH demonstrating a favorable outcome despite modified therapy.
Competing Interests: The authors declare no conflict of interest.
(© 2022 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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