Hemophagocytic Lymphohistiocytosis Associated with <i>Salmonella typhi</i> Infection in a Child: A Case Report with Review of Literature

Uribe-Londono, Juanita; Castaño-Jaramillo, Lina María; Penagos-Tascon, Laura; Restrepo-Gouzy, Andrea; Escobar-Gonzalez, Andres-Felipe

doi:10.1155/2018/6236270

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…The most common cause of IAHS in developed countries was EBV infection 31 followed by other viruses, that is, CMV and herpes simplex virus 32 . On the contrary, tropical infections, that is, Salmonella spp., 33 dengue virus, 14,29 malaria, 13 and Leishmania spp 34 . were predominantly addressed in developing countries as in Thailand.…”

Section: Discussionmentioning

confidence: 99%

Pediatric hemophagocytic lymphohistiocytosis in a tropical country: Results of a multicenter study in Thailand

Rungrojjananon

Pakakasama

Winaichatsak

et al. 2022

Asia-Pac J Clncl Oncology

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Background Hemophagocytic lymphohistiocytosis (HLH) is a rare, life‐threatening condition caused by genetic mutation or various triggers disturbing the immune system. Methods A multicenter retrospective study of pediatric patients with HLH receiving a diagnosis between January 2005 and December 2019 from three pediatric oncology centers was conducted to explore the clinical characteristics and determine prognostic factors associated with outcomes among Thai children. Results In all, 78 patients with HLH with a median age at diagnosis of 3.17 (range, .08–17.83) years were enrolled. The male to female ratio was 1.2:1. The most common type of HLH was infection‐associated hemophagocytic syndrome (IAHS) (n = 59, 75%) of which Epstein‐Barr virus was the most common pathogen. Thrombocytopenia, hyperbilirubinemia, and treatment response at weeks 2 and 8 after initiating treatment were associated with mortality. Platelet count <50,000 cells/mm3 was the only independent prognostic factor to define survival outcome (p‐value .035). Two‐year overall survival rate was 71.3% (95% confidence interval, 59.2%–80.3%). Survival rates between IAHS, malignant associated HLH, macrophage activation syndrome, and unspecific HLH did not significantly differ (p‐value .571). Conclusion IAHS was the most common cause among pediatric HLH in Thailand. The outcomes of Thai children with HLH were comparable to those of developed countries. Platelet count <50,000 cells/mm3 was the only independent prognostic factor to define survival outcome.

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Section: Discussionmentioning

confidence: 99%

Pediatric hemophagocytic lymphohistiocytosis in a tropical country: Results of a multicenter study in Thailand

Rungrojjananon

Pakakasama

Winaichatsak

et al. 2022

Asia-Pac J Clncl Oncology

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“…[ 7 8 ] To the best of our knowledge, there are six cases of sHLH as a complication of typhoid fever by S. typhi reported in the pediatric population. [ 9 ] Thorough literature search did not reveal similar case with rare associations of this dual complication of meningitis and hemophagocytosis in the same patient. In our case, salmonellosis presented with HLH as a primary complication followed by meningitis later on.…”

Section: Discussionmentioning

confidence: 90%

A Rare Case of Salmonella meningitis and Hemophagocytic Lymphohistiocytosis

Dange

Sawant

Dash

et al. 2021

Journal of Global Infectious Diseases

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Enteric fever is a common infectious disease of the tropical world. Common age group involved is children aged between 5 and 10 years. In addition to diarrhea, it may lead to extraintestinal infections including aseptic meningitis, hepatitis, cholecystitis, acute abdomen, intestinal perforation, pneumonia, psychosis, and ataxia. Hematologic complications leading to hemophagocytosis have a prevalence of < 1%. Salmonella meningitis has an incidence of 6% with poor prognosis neurological sequelae. We report a rare case of enteric fever that presented with hemophagocytic syndrome and S. meningitis . Response to third-generation cephalosporins is dramatic, eventually giving good prognosis.

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“…Navneet et al reported a sHLH patient triggered by S.typhi was treated by ceftriaxone along with supportive care [11]. Juanita Uribe-Londono et al reported a sHLH patient triggered by S.typhi was treated by piperacillin-tazobactam, intravenous immunoglobulin, and cipro oxacin, who completed 14 days of antibiotic treatment and discharged from hospital [12]. Arslansoyu Çamlar et al reported an early diagnosis of S.typhi, treatment with parenteral ceftriaxon and supportive treatment prevented progression of HLH [13].…”

Section: Discussionmentioning

confidence: 99%

Low ratio of IL-10 to IFN-γ and Low IL-10 level indicate good prognosis in Salmonella enterica serovar Typhimurium triggered secondary hemophagocytic lymphohistiocytosis: a case report and literature review

Chen

Liang

et al. 2023

Preprint

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Background: Secondary hemophagocytic lymphohistiocytosis triggered by Salmonella enterica serovar Typhimurium is rare in pediatric patients. There is a specific cytokine pattern to differentiate HLH subtypes, including IFN-γ, IL-10, and IL-6, and the ratio of IL-10 to IFN-γ, which can guide HLH treatments choice. Case presentation: We present a pediatric 9-year old patient who presented with fever and pancytopenia for three days into our hospital, who showed positive results of Salmonella enterica serovar Typhimurium, Human Rhino Virus and Mycoplasma Pneumoniae infections. At the time of admission to our institution, the patient’s Th1/Th2 cytokine results showed that IL-6 was 326 pg/ml, IL-10 was 9.1 pg/ml, and IFN-γ was 246.7 pg/ml, with a ratio of IL-10 to IFN-γ was 0.04. In this study, this patient received meropenem, linezolid, and cefoperazone/sulbactam for anti-infection therapy, combined with high dose methylprednisolone therapy and anti-shock supportive treatments for twice. After careful evaluation, this patient did not receive HLH chemotherapy during the whole disease course, and he recovered well. Conclusions: Early antimicrobial and supportive treatment would be enough for Salmonellatriggered sHLH with a ratio of IL-10 to IFN-γ ≤ 1.33, and IL-10 ≤ 10.0 pg/ml, and/or IFN-γ ≤ 225 pg/ml on admission, and HLH-94/2004 protocol was not necessary in such condition.

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Hemophagocytic Lymphohistiocytosis Associated with Salmonella typhi Infection in a Child: A Case Report with Review of Literature

Cited by 8 publications

References 10 publications

Pediatric hemophagocytic lymphohistiocytosis in a tropical country: Results of a multicenter study in Thailand

Pediatric hemophagocytic lymphohistiocytosis in a tropical country: Results of a multicenter study in Thailand

A Rare Case of Salmonella meningitis and Hemophagocytic Lymphohistiocytosis

Low ratio of IL-10 to IFN-γ and Low IL-10 level indicate good prognosis in Salmonella enterica serovar Typhimurium triggered secondary hemophagocytic lymphohistiocytosis: a case report and literature review

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