A Rare Cause of Hemophagocytic Lymphohistiocytosis: Fusobacterium Infection—A Case Report and Review of the Literature
Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome characterized by excessive activation of the immune system. Bacterial infections are very rare precipitants of this disease. A 19-year-old gentleman presented with headache, fatigue, and malaise. He was found to be hypotensive, tachycardic,...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2016/4839146 |
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| author | Ghulam Rehman Mohyuddin Heather J. Male |
| author_facet | Ghulam Rehman Mohyuddin Heather J. Male |
| author_sort | Ghulam Rehman Mohyuddin |
| collection | DOAJ |
| description | Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome characterized by excessive activation of the immune system. Bacterial infections are very rare precipitants of this disease. A 19-year-old gentleman presented with headache, fatigue, and malaise. He was found to be hypotensive, tachycardic, and febrile. Broad spectrum antibiotics were initiated, and a lumbar puncture ruled out meningitis. Patient progressively developed shock that required use of vasopressors, as well as renal and respiratory failure. Blood cultures grew Fusobacterium necrophorum. Given continued fevers despite appropriate antimicrobials, a bone marrow biopsy was performed revealing increased histiocytes with hemophagocytosis. Dexamethasone was added with dramatic clinical improvement. Our case highlights Fusobacterium as a rare precipitant of HLH and proves that a high index of clinical suspicion is crucial for early diagnosis of HLH, allowing for prompt initiation of HLH-specific immunosuppressive therapy that can be life-saving. |
| format | Article |
| id | doaj-art-af1ba7b21e654c648f98ce63ef458b17 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-af1ba7b21e654c648f98ce63ef458b172025-02-03T01:06:45ZengWileyCase Reports in Hematology2090-65602090-65792016-01-01201610.1155/2016/48391464839146A Rare Cause of Hemophagocytic Lymphohistiocytosis: Fusobacterium Infection—A Case Report and Review of the LiteratureGhulam Rehman Mohyuddin0Heather J. Male1Kansas University Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USADivision of Hematologic Malignancies and Cellular Therapeutics (HMCT), Department of Internal Medicine, University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Mailstop 5003, Westwood, KS 66205, USAHemophagocytic lymphohistiocytosis (HLH) is a rare syndrome characterized by excessive activation of the immune system. Bacterial infections are very rare precipitants of this disease. A 19-year-old gentleman presented with headache, fatigue, and malaise. He was found to be hypotensive, tachycardic, and febrile. Broad spectrum antibiotics were initiated, and a lumbar puncture ruled out meningitis. Patient progressively developed shock that required use of vasopressors, as well as renal and respiratory failure. Blood cultures grew Fusobacterium necrophorum. Given continued fevers despite appropriate antimicrobials, a bone marrow biopsy was performed revealing increased histiocytes with hemophagocytosis. Dexamethasone was added with dramatic clinical improvement. Our case highlights Fusobacterium as a rare precipitant of HLH and proves that a high index of clinical suspicion is crucial for early diagnosis of HLH, allowing for prompt initiation of HLH-specific immunosuppressive therapy that can be life-saving.http://dx.doi.org/10.1155/2016/4839146 |
| spellingShingle | Ghulam Rehman Mohyuddin Heather J. Male A Rare Cause of Hemophagocytic Lymphohistiocytosis: Fusobacterium Infection—A Case Report and Review of the Literature Case Reports in Hematology |
| title | A Rare Cause of Hemophagocytic Lymphohistiocytosis: Fusobacterium Infection—A Case Report and Review of the Literature |
| title_full | A Rare Cause of Hemophagocytic Lymphohistiocytosis: Fusobacterium Infection—A Case Report and Review of the Literature |
| title_fullStr | A Rare Cause of Hemophagocytic Lymphohistiocytosis: Fusobacterium Infection—A Case Report and Review of the Literature |
| title_full_unstemmed | A Rare Cause of Hemophagocytic Lymphohistiocytosis: Fusobacterium Infection—A Case Report and Review of the Literature |
| title_short | A Rare Cause of Hemophagocytic Lymphohistiocytosis: Fusobacterium Infection—A Case Report and Review of the Literature |
| title_sort | rare cause of hemophagocytic lymphohistiocytosis fusobacterium infection a case report and review of the literature |
| url | http://dx.doi.org/10.1155/2016/4839146 |
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