Hemophagocytic Lymphohistiocytosis Associated with Coinfection of Scrub Typhus and Dengue Fever in a Child: A Case Report

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon life-threatening immune disorder that may be either primary or secondary to infection, malignancy, or rheumatological disease. In tropical countries like India, secondary HLH is more commonly seen. Both Dengue fever and scrub typhus, which result in more than half of all acute undifferentiated febrile illnesses in tropics, can occasionally result in HLH. Early diagnosis of HLH and institution of appropriate treatment can result in a good outcome. Although coinfections are common in tropical countries, HLH due to coinfections is rare. We are reporting a child diagnosed with HLH associated with coinfection with scrub typhus and Dengue fever that received early supportive treatment and recovered without needing chemotherapy.

Keywords

• hemophagocytic lymphohistiocytosis
• dengue infection
• scrub typhus
• coinfection