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Epstein-Barr Virus Associated Hemophagocytic Syndrome after Scrub Typhus Infection

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초록

There have been a small number of cases of scrub typhus-associated hemophagocytic syndrome (HPS), most of which were treated successfully using adequate antibiotics. Here, we report a case of Epstein-Barr virus (EBV)-associated HPS after scrub typhus infection that was not improved using antirickettsial treatment. A 73-year-old male who had been diagnosed with scrub typhus according to an eschar and a positive serology was transferred to our institution because of a persistent fever despite 7-day doxycycline therapy. Physical and laboratory data showed hepatosplenomegaly, bicytopenia, hyperferritinemia, and hypofibrinogenemia. A bone marrow examination (BM) revealed hypercellular marrow with hemophagocytosis and histiocyte infiltration. EBV was detected in BM aspirates using polymerase chain reaction. After a diagnosis of HPS was made, the patient was treated successfully using high-dose steroids.

Abstract

There have been a small number of cases of scrub typhus-associated hemophagocytic syndrome (HPS), most of which were treated successfully using adequate antibiotics. Here, we report a case of Epstein-Barr virus (EBV)-associated HPS after scrub typhus infection that was not improved using antirickettsial treatment. A 73-year-old male who had been diagnosed with scrub typhus according to an eschar and a positive serology was transferred to our institution because of a persistent fever despite 7-day doxycycline therapy. Physical and laboratory data showed hepatosplenomegaly, bicytopenia, hyperferritinemia, and hypofibrinogenemia. A bone marrow examination (BM) revealed hypercellular marrow with hemophagocytosis and histiocyte infiltration. EBV was detected in BM aspirates using polymerase chain reaction. After a diagnosis of HPS was made, the patient was treated successfully using high-dose steroids.

참고문헌 (20)

  1. Fisman DN, "Hemophagocytic syndromes and infection", Emerg Infect Dis, 6, pp.601~608 (2000)
  2. Scott R, "Histiocytic medullary reticulosis", Lancet, 2, pp.194~198 (1939)
  3. 이호권, "춘천 지역에서 발생한 쯔쯔가무시병의 임상적 특징", 대한내과학회지, 69(2), pp.190~196 (2005), 대한내과학회
  4. Varghese GM, "Scrub typhus among hospitalised patients with febrile illness in South India: magnitude and clinical predictors", J Infect, 52, pp.56~60 (2006)
  5. Fujiwara F, "Hypercytokinemia in hemophagocytic syndrome", Am J Pediatr Hematol Oncol, 15, pp.92~98 (1993)
  6. Henter JI, "HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis", Pediatr Blood Cancer, 48, pp.124~131 (2007)
  7. Rouphael NG, "Infections associated with haemophagocytic syndrome", Lancet Infect Dis, 7, pp.814~822 (2007)
  8. Weitzman S, "Approach to hemophagocytic syndromes", Hematology Am Soc Hematol Educ Program, 2011, pp.178~183 (2011)
  9. Lay JD, "Epstein-barr virus latent membrane protein-1 mediates upregulation of tumor necrosis factor-alpha in EBV-infected T cells: implications for the pathogenesis of hemophagocytic syndrome", J Biomed Sci, 10, pp.146~155 (2003)
  10. Lay JD, "Upregulation of tumor necrosis factor-alpha gene by Epstein-Barr virus and activation of macrophages in Epstein-Barr virus-infected T cells in the pathogenesis of hemophagocytic syndrome", J Clin Invest, 100, pp.1969~1979 (1997)
  11. Filipovich AH, "Hemophagocytic lymphohistiocytosis (HLH) and related disorders", Hematology Am Soc Hematol Educ Program, pp.127~131 (2009)
  12. Yamashita N, "Virological aspects of Epstein-Barr virus infections", Acta Med Okayama, 59, pp.239~246 (2005)
  13. Walton AH, "Reactivation of multiple viruses in patients with sepsis", PLoS One, 9, pp.e98819~ (2014)
  14. Takami A, "Tsutsugamushi disease (scrub typhus)-associated hemophagocytic syndrome", Int J Hematol, 75, pp.337~338 (2002)
  15. Miyakawa K, "Tsutsugamushi disease with hemophagocytosis complicated by Parvovirus B19 infection", Nihon Naika Gakkai Zasshi, 95, pp.2544~2546 (2006)
  16. Premaratna R, "Unusual pancytopenia secondary to haemophagocytosis syndrome in rickettsioses", Trans R Soc Trop Med Hyg, 103, pp.961~963 (2009)
  17. 김형욱, "쯔쯔가무시병과 동반된 혈구탐식 림프조직구증으로 사망한 1예", Infection and Chemotherapy, 42(4), pp.266~270 (2010), 대한감염학회
  18. Hong JH, "A case of Epstein-Barr virus associated hemophagocytic lymphohistiocytosis after scrub typhus infection", Clin Pediatr Hematol Oncol, 19, pp.49~52 (2012)
  19. Lin YH, "A case report of scrub typhus-associated hemophagocytic syndrome and a review of literature", Jpn J Infect Dis, 67, pp.115~117 (2014)
  20. 강철인, "국내 젊은 남성들의 Epstein-Barr 바이러스항체보유율", Infection and Chemotherapy, 39(2), pp.93~94 (2007), 대한감염학회

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