Hemophagocytic syndrome is a rare life-threatening disorder that can be triggered by various conditions such as HIV infection and opportunistic agents. We report a case of disseminated toxoplasmosis complicated with severe hemophagocytic syndrome and revealing an unknown acquired immunodeficiency syndrome. The patient presented with multiple organ failure in intensive care unit. Once diagnosed, he benefitted from etoposide infusion, administration of specific anti-toxoplasmosis treatments and secondary antiretroviral therapy. He was alive at intensive care unit discharge and returned home with little sequalae. This case illustrates both the importance of rapid investigations of hemophagocytic syndrome etiologies in HIV positive patients and the necessity to prompt etoposide and specific treatments in order to improve potentially dramatic outcomes.
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http://dx.doi.org/10.1016/j.revmed.2022.07.016 | DOI Listing |
Cureus
December 2024
Internal Medicine, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, Chaves, PRT.
Fever is a classic reason for hospital visits, sometimes requiring admission. Its etiologies are numerous, ranging from simple and relatively common conditions to rare and complex pathologies, for which the differential diagnosis can present a true challenge for internists. A 78-year-old healthy female is referred to the emergency department due to marked fatigue for the past four months, with no other symptoms.
View Article and Find Full Text PDFClin Nucl Med
November 2024
Department of Radiology, University of Washington, Seattle, WA.
A 9-month-old girl was evaluated for recurrent fevers, rash, and indurated plaques, with laboratories demonstrating hyperferritinemia, hypertriglyceridemia, and pancytopenia, concerning for hemophagocytic lymphohistiocytosis. Biopsy of thigh lesion ultimately demonstrated subcutaneous panniculitis-like T-cell lymphoma. In a rare neoplasm of cytotoxic T-cells, subcutaneous panniculitis-like T-cell lymphoma presents with subcutaneous nodules in all age groups including children.
View Article and Find Full Text PDFBiomedicines
December 2024
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia.
Macrophage activation syndrome (MAS) can be regarded as a key factor determining the severity of multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C), and often requires treatment in the intensive care unit (ICU) to avoid life-threatening complications. No reputable specific criteria for the diagnosis of MAS in MIS-C patients have yet been identified, and criteria currently used for the diagnosis of hemophagocytic syndromes, such as HLH-2004, MAS-2005, and MAS-2016, are not sufficient for MAS in MIS-C. Our goal in this study was to work out the criteria for the early diagnosis of MAS in MIS-C.
View Article and Find Full Text PDFCureus
December 2024
Department of Internal Medicine, Unidade Local de Saúde Entre Douro e Vouga, Santa Maria da Feira, PRT.
Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal entity characterized by an unregulated activation of the immune system. In the adult population, it is most commonly secondary to infectious, autoimmune, or neoplastic diseases. We present a case of a 23-year-old female diagnosed with infectious mononucleosis and hospitalized due to a persistent three-week fever and malaise with a new onset of jaundice and findings compatible with acute hepatitis and hepatosplenomegaly.
View Article and Find Full Text PDFACG Case Rep J
January 2025
Stony Brook Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Stony Brook University Hospital, Stony Brook, NY.
Although herpes simplex virus, Epstein-Barr virus, and hemophagocytic lymphohistiocytosis are known causes of severe acute liver injury with or without liver failure, these diseases occur almost exclusively in immunocompromised and elderly patients. We report a case of an immunocompetent young man with no medical history who presented with a subacute cough and persistent fevers in the setting of a penile chancre. He was found to have severely elevated liver chemistries and was subsequently diagnosed with hemophagocytic lymphohistiocytosis because of disseminated herpes simplex virus type 1 and Epstein-Barr virus coinfection.
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