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A Case of Death Due to Hemophagocytic Lymphohistiocytosis Accompanied by Scrub Typhus
Hyung Wook Kim1, Bo Sik Choi1, Jong Hyung Kim1, Young Min Shin1, Soon Jung Lee1, Sung Ryul Kim2, and Jae-Bum Jun1
Departments of 1Internal Medicine and 2Laboratory Medicine, University of Ulsan College of Medicine, Ulsan, Korea
Vol.42 Num.4 (p266~270)
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.
Keywords : Scrub typhus, Hemophagocytic lymphohistiocytosis, Hemophagocytic syndrome