Leptospirosis Complicated by Secondary Hemophagocytic Lymphohistiocytosis in a Child: A Rare Association

Aims and background: Leptospirosis is caused by spirochetes of the genus <italic>Leptospira</italic>. In most patients, it is a very mild illness. However, some patients develop complications due to the involvement of multiple organ systems. Hemophagocytic lymphohistiocytosis (HLH) is ch...

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Main Authors: Madhumita Nandi, Swarupananda Bera
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2025-01-01
Series:Pediatric Infectious Disease
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Online Access:https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1446
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author Madhumita Nandi
Swarupananda Bera
author_facet Madhumita Nandi
Swarupananda Bera
author_sort Madhumita Nandi
collection DOAJ
description Aims and background: Leptospirosis is caused by spirochetes of the genus <italic>Leptospira</italic>. In most patients, it is a very mild illness. However, some patients develop complications due to the involvement of multiple organ systems. Hemophagocytic lymphohistiocytosis (HLH) is characterized by prolonged fever, hepatosplenomegaly and cytopenias, hyperferritinemia and hypertriglyceridemia, hypofibrinogenemia, and hemophagocytosis in lymphoreticular system. It may occur primarily as a result of some genetic predisposition or secondarily associated with certain infections, autoimmune, and malignant conditions [secondary hemophagocytic lymphohistiocytosis (sHLH)]. Case description: We report a 9-year-old girl with secondary HLH associated with Leptospira infection treated successfully with appropriate antibiotics and intravenous immunoglobulin. Conclusion: Progressive cytopenia associated with deteriorating clinical condition with recurrence or nonabatement of fever should lead the clinician to suspect sHLH. Clinical significance: Leptospirosis precipitating HLH has rarely been reported.
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spelling doaj-art-d96336b07e74415ba2d44fd2cd8723b02025-08-20T02:16:45ZengJaypee Brothers Medical PublisherPediatric Infectious Disease2582-49882025-01-0171272910.5005/jp-journals-10081-14468Leptospirosis Complicated by Secondary Hemophagocytic Lymphohistiocytosis in a Child: A Rare AssociationMadhumita Nandi0Swarupananda Bera1Madhumita Nandi, Department of Paediatrics, North Bengal Medical College & Hospital, Kolkata, West Bengal, India, Phone: +91 9433166790Department of Paediatrics, North Bengal Medical College & Hospital, Kolkata, West Bengal, IndiaAims and background: Leptospirosis is caused by spirochetes of the genus <italic>Leptospira</italic>. In most patients, it is a very mild illness. However, some patients develop complications due to the involvement of multiple organ systems. Hemophagocytic lymphohistiocytosis (HLH) is characterized by prolonged fever, hepatosplenomegaly and cytopenias, hyperferritinemia and hypertriglyceridemia, hypofibrinogenemia, and hemophagocytosis in lymphoreticular system. It may occur primarily as a result of some genetic predisposition or secondarily associated with certain infections, autoimmune, and malignant conditions [secondary hemophagocytic lymphohistiocytosis (sHLH)]. Case description: We report a 9-year-old girl with secondary HLH associated with Leptospira infection treated successfully with appropriate antibiotics and intravenous immunoglobulin. Conclusion: Progressive cytopenia associated with deteriorating clinical condition with recurrence or nonabatement of fever should lead the clinician to suspect sHLH. Clinical significance: Leptospirosis precipitating HLH has rarely been reported.https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1446case reporthemophagocytic lymphohistiocytosisleptospirosissecondary hemophagocytic lymphohistiocytosis
spellingShingle Madhumita Nandi
Swarupananda Bera
Leptospirosis Complicated by Secondary Hemophagocytic Lymphohistiocytosis in a Child: A Rare Association
Pediatric Infectious Disease
case report
hemophagocytic lymphohistiocytosis
leptospirosis
secondary hemophagocytic lymphohistiocytosis
title Leptospirosis Complicated by Secondary Hemophagocytic Lymphohistiocytosis in a Child: A Rare Association
title_full Leptospirosis Complicated by Secondary Hemophagocytic Lymphohistiocytosis in a Child: A Rare Association
title_fullStr Leptospirosis Complicated by Secondary Hemophagocytic Lymphohistiocytosis in a Child: A Rare Association
title_full_unstemmed Leptospirosis Complicated by Secondary Hemophagocytic Lymphohistiocytosis in a Child: A Rare Association
title_short Leptospirosis Complicated by Secondary Hemophagocytic Lymphohistiocytosis in a Child: A Rare Association
title_sort leptospirosis complicated by secondary hemophagocytic lymphohistiocytosis in a child a rare association
topic case report
hemophagocytic lymphohistiocytosis
leptospirosis
secondary hemophagocytic lymphohistiocytosis
url https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1446
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AT swarupanandabera leptospirosiscomplicatedbysecondaryhemophagocyticlymphohistiocytosisinachildarareassociation