Flea-Borne Typhus Causing Hemophagocytic Lymphohistiocytosis: An Autopsy Case

Infection with members of the order Rickettsiales (the genera Rickettsia, Anaplasma, Orientia, and Ehrlichia) is known to cause hemophagocytic lymphohistiocytosis (HLH). The literature is scant on flea-borne typhus (FBT) being implicated in this process. We present a case of autopsy-proven HLH cause...

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Bibliographic Details
Published in:Infectious disease reports 2023-02, Vol.15 (1), p.132-141
Main Authors: Chandramohan, Divya, Awobajo, Moyosore, Fisher, Olivia, Dayton, Christopher L., Anstead, Gregory M.
Format: Article
Language:English
Subjects:
Antibiotics
Autopsies
Autopsy
Blood
Case Report
Dehydrogenases
Diabetes
Diabetes mellitus
Diabetic ketoacidosis
fatal
flea-borne typhus
Hemoglobin
hemophagocytic lymphohistiocytosis
Hepatitis
Histiocytosis
HIV
Human immunodeficiency virus
Hypertension
Illnesses
Infections
Intensive care
Ketoacidosis
Laboratories
Literature reviews
Lymphatic diseases
Lymphocytosis
Murine typhus
Patients
Phosphatase
Rickettsia felis
Rickettsia typhi
Rickettsiales
Tropical diseases
Typhus
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Summary:Infection with members of the order Rickettsiales (the genera Rickettsia, Anaplasma, Orientia, and Ehrlichia) is known to cause hemophagocytic lymphohistiocytosis (HLH). The literature is scant on flea-borne typhus (FBT) being implicated in this process. We present a case of autopsy-proven HLH caused by FBT in a 71-year-old diabetic female who was initially suspected of having diabetic ketoacidosis who rapidly suffered decompensated multi-organ failure. Although she was suspected of having FBT and HLH pre-mortem, due to her rapid progression to multi-organ failure, she was transitioned to comfort care by her family five days after admission. A literature search yielded five other cases of HLH secondary to FBT, which are analyzed in this review. The literature on HLH occurring with infection due to other members of the order Rickettsiales is also surveyed.
ISSN:2036-7449
2036-7430
2036-7449
DOI:10.3390/idr15010014