Scrub typhus-associated severe hemophagocytic lymphohistiocytosis with encephalomyelitis leading to permanent sequelae: a case report and review of the literature.

Research paper by Dong Kyun DK Han, Hee Jo HJ Baek, Myung-Geun MG Shin, Jin Woong JW Kim, Hoon H Kook, Tai Ju TJ Hwang

Indexed on: 26 May '12Published on: 26 May '12Published in: Journal of pediatric hematology/oncology


Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal disorder. There have been a few reports on HLH secondary to scrub typhus in adults. Here, we describe the case of a 9-year-old Korean girl who presented with the typical findings of HLH. Despite adequate antirickettsial and HLH treatment, the neurological impairment worsened and remained. This is the first case report of severe neurological impairment resulting from the very rare association of HLH with scrub typhus. Therefore, in endemic areas, a high index of suspicion for scrub typhus is warranted in patients presenting with HLH.