A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine Typhus
Hemophagocytic lymphohistiocytosis (HLH) is a serious hyperinflammatory condition with hyperactive cytotoxic T cells and macrophages that can be triggered by various infections, malignancies, and rheumatologic conditions. Herein, we present a rare case of secondary HLH due to probable murine typhus....
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American College of Physicians
2024-12-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0690 |
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| author | Shreya Kondle Sharon A. Secola Khoan Vu |
| author_facet | Shreya Kondle Sharon A. Secola Khoan Vu |
| author_sort | Shreya Kondle |
| collection | DOAJ |
| description | Hemophagocytic lymphohistiocytosis (HLH) is a serious hyperinflammatory condition with hyperactive cytotoxic T cells and macrophages that can be triggered by various infections, malignancies, and rheumatologic conditions. Herein, we present a rare case of secondary HLH due to probable murine typhus. A 65-year-old man presented with generalized weakness, anemia, thrombocytopenia, and elevated liver enzymes. Evaluation revealed extremely elevated ferritin and presence of hemophagocytosis on bone marrow aspirate. He was initially treated with dexamethasone and etoposide for suspected HLH, but additional evaluation confirmed typhus group positivity. With initiation of doxycycline, the patient's clinical condition rapidly improved. |
| format | Article |
| id | doaj-art-f990c1cacc14456594c74a9f1d3a5ec1 |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-f990c1cacc14456594c74a9f1d3a5ec12025-08-20T03:18:48ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-12-0131210.7326/aimcc.2024.0690A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine TyphusShreya Kondle0Sharon A. Secola1Khoan Vu21Department of Internal Medicine, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas2Department of Pathology, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas3Texas Oncology–Presbyterian Cancer Center Dallas, Dallas, TexasHemophagocytic lymphohistiocytosis (HLH) is a serious hyperinflammatory condition with hyperactive cytotoxic T cells and macrophages that can be triggered by various infections, malignancies, and rheumatologic conditions. Herein, we present a rare case of secondary HLH due to probable murine typhus. A 65-year-old man presented with generalized weakness, anemia, thrombocytopenia, and elevated liver enzymes. Evaluation revealed extremely elevated ferritin and presence of hemophagocytosis on bone marrow aspirate. He was initially treated with dexamethasone and etoposide for suspected HLH, but additional evaluation confirmed typhus group positivity. With initiation of doxycycline, the patient's clinical condition rapidly improved.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0690 |
| spellingShingle | Shreya Kondle Sharon A. Secola Khoan Vu A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine Typhus Annals of Internal Medicine: Clinical Cases |
| title | A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine Typhus |
| title_full | A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine Typhus |
| title_fullStr | A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine Typhus |
| title_full_unstemmed | A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine Typhus |
| title_short | A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine Typhus |
| title_sort | probable rickettsial trigger for hemophagocytic lymphohistiocytosis murine typhus |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0690 |
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