Scrub Typhus-Associated Hemophagocytic Lymphohistiocytosis: Not a Rare Entity in Pediatric Age Group

Abstract Background Our goal was to study the demographic, clinical and laboratory profile outcome of scrub typhus-associated hemophagocytic lymphohistiocytosis (HLH) in pediatric age group. Methods We conducted a prospective observational tertiary care teaching hospital over period 1 year. Children group month 12 years with IgM ELISA positive for typhus were included study. HLH diagnosed using HLH-2004 criteria. Demographic, profile, treatment patients noted also compared non-HLH patients. Results Among 58 children infection, 18 had HLH. The mean 35.3 ± 44.8 months 61% male. Anemia, thrombocytopenia hyperferritinemia seen all Hypertriglyceridemia, hypofibrinogenemia coagulopathy 78%, 56% 44%, respectively. All treated intravenous doxycycline an average duration 9.5 days. Intravenous immunoglobulin methylprednisolone given 33% 22% cases, Complications like acute respiratory distress syndrome (ARDS) (p = 0.001) MODS 0.004) significantly high Younger (<3 years), fever > 7 days, presence convulsion, ARDS predictors Conclusion infected is being increasingly recognized. age, prolonged fever, should alert clinicians risk Treating primary cause usually cures disease immunomodulator therapy need not be routinely administered.