Typhoid Fever Accompanied With Hematopoetic Lymphohistiocytosis and Rhabdomyolysis in a Refugee Child

Yaşar, Akkız Şahin; Karaman, Kamuran; Geylan, Hadi; Çetin, Mecnun; Güven, Burcu; Öner, Ahmet Faik

doi:10.1097/mph.0000000000001400

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…Currently, dexamethasone, etoposide, cyclosporine A, and ruxolitinib are main choice in HLH treatment [17]. [20]. In this study, after careful evaluation, our patient did not receive HLH chemotherapy during the whole disease course.…”

Section: Discussionmentioning

confidence: 79%

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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Section: Discussionmentioning

confidence: 79%

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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show abstract

“…Several researchers have shown that antimicrobial and supportive treatment alone are effective[ 5 , 19 - 23 ]. However, many researchers have used both antimicrobial treatment and the HLH protocol to treat sHLH triggered by Salmonella infections[ 6 , 10 , 24 ]. In this study, after careful evaluation, our patient did not receive HLH chemotherapy during the whole disease course.…”

Section: Discussionmentioning

confidence: 99%

“…sHLH can be triggered by the Epstein-Barr virus (EBV)[ 3 ], cytomegalovirus[ 4 ], and Salmonella enterica serovar typhimurium [ 5 , 6 ], etc. S. typhimurium is a Gram-negative bacterium that depends on an essential inflammatory response to colonize the intestinal tract, causing self-limiting gastroenteritis in humans[ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Low interleukin-10 level indicates a good prognosis in Salmonella enterica serovar typhimurium-induced pediatric hemophagocytic lymphohistiocytosis: A case report

Chen,

Xu,

2024

World J Clin Cases

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BACKGROUND Secondary hemophagocytic lymphohistiocytosis (sHLH) triggered by Salmonella enterica serovar Typhimurium is rare in pediatric patients. There is no consensus on how to treat S. typhimurium -triggered sHLH. CASE SUMMARY A 9-year-old boy with intermittent fever for 3 d presented to our hospital with positive results for S. typhimurium , human rhinovirus, and Mycoplasma pneumoniae infections. At the time of admission to our institution, the patient’s T helper 1/T helper 2 cytokine levels were 326 pg/mL for interleukin 6 (IL-6), 9.1 pg/mL for IL-10, and 246.7 pg/mL for interferon-gamma (IFN-γ), for which the ratio of IL-10 to IFN-γ was 0.04. In this study, the patient received meropenem, linezolid, and cefoperazone/sulbactam in combination with high-dose methylprednisolone therapy (10 mg/kg/d for 3 d) and antishock supportive treatment twice. After careful evaluation, this patient did not receive HLH chemotherapy and recovered well. CONCLUSION S. Typhimurium infection-triggered sHLH patient had a ratio of IL-10 to IFN-γ ≤ 1.33, an IL-10 concentration ≤ 10.0 pg/mL, and/or an IFN-γ concentration ≤ 225 pg/mL at admission. Early antimicrobial and supportive treatment was sufficient, and the HLH-94/2004 protocol was not necessary under these conditions.

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Typhoid with pancytopenia: Revisiting a forgotten foe: Two case reports

Saha¹,

Selvaraj²,

Viswanathan³

et al. 2022

World J Hematol

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Typhoid Fever Accompanied With Hematopoetic Lymphohistiocytosis and Rhabdomyolysis in a Refugee Child

Cited by 3 publications

References 5 publications

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

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

Low interleukin-10 level indicates a good prognosis in Salmonella enterica serovar typhimurium-induced pediatric hemophagocytic lymphohistiocytosis: A case report

Typhoid with pancytopenia: Revisiting a forgotten foe: Two case reports

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