Infect Chemother.  2010 Aug;42(4):266-270. 10.3947/ic.2010.42.4.266.

A Case of Death Due to Hemophagocytic Lymphohistiocytosis Accompanied by Scrub Typhus

• Kim HW
• Choi BS
• Kim JH
• Shin YM
• Lee SJ
• Kim SR
• Jun JB

• KMID: 1457391
• DOI: http://doi.org/10.3947/ic.2010.42.4.266

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare disease with a high mortality rate. It is associated with a variety of bacterial, viral, fungal, and parasitic infections. In the literature, there are several cases of HLH associated with scrub typhus in adults, all of which were successfully treated with antibiotic therapy for scrub typhus. This report describes a case of HLH accompanied by scrub typhus in an 81-year-old woman, in whom the disease progressed despite doxycyclin therapy. The patient refused to receive immunosuppressive chemotherapy for HLH and died 5 weeks after admission due to multi-organ failure. To our knowledge, this is the first case of death due to scrub typhus-associated HLH in an adult.

Keyword

Scrub typhus; Hemophagocytic lymphohistiocytosis; Hemophagocytic syndrome

MeSH Terms

Adult
Aged, 80 and over
Female
Humans
Lymphohistiocytosis, Hemophagocytic
Rare Diseases
Scrub Typhus

Figure

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  Figure 1 Contrast-enhanced abdominal computed tomography on admission shows hepatosplenomegaly.

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  Figure 2 Microscopic finding of bone marrow aspiration shows hemophagocytosis of neutrophil, normoblasts, and platelets (Wright-Giemsa stain, ×1,000).

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