Visceral leishmaniasis with haemophagocytic lymphohistiocytosis.
Administration, Intravenous
Adult
Amphotericin B
/ administration & dosage
Bone Marrow Examination
Fever
/ etiology
Humans
Hydrocortisone
/ administration & dosage
Leishmania donovani
/ isolation & purification
Leishmaniasis, Visceral
/ complications
Lymphohistiocytosis, Hemophagocytic
/ drug therapy
Male
immunology
medical management
tropical medicine (infectious disease)
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
13 Feb 2019
13 Feb 2019
Historique:
entrez:
16
2
2019
pubmed:
16
2
2019
medline:
30
5
2019
Statut:
epublish
Résumé
A 27-year-old man presented with high-grade intermittent fever for 4 months, generalised fatigue for 2 months, intermittent gum bleeds for 1 month and loss of weight of 15 kg. He appeared cachectic with generalised wasting, had pallor and features of reticuloendothelial system proliferation. His liver span was 17 cm. He had massive splenomegaly. His cardiovascular, respiratory and neurological examination were normal. He was diagnosed to have visceral leishmaniasis (VL) based on bone marrow (BM) examination that showed Leishmania donovani (LD) bodies and was treated with liposomal amphotericin (LA). During the course of therapy, he developed bleeding from various mucosal and venepuncture sites. His further evaluation, which included a repeat BM aspirate, showed haemophagocytes. Final diagnosis made was VL with secondary haemophagocytic lymphohistiocytosis. He was continued on LA with intravenous hydrocortisone. He developed refractory distributive shock with multiorgan dysfunction and succumbed to his illness.
Identifiants
pubmed: 30765439
pii: 12/2/e226361
doi: 10.1136/bcr-2018-226361
pmc: PMC6381973
pii:
doi:
Substances chimiques
liposomal amphotericin B
0
Amphotericin B
7XU7A7DROE
Hydrocortisone
WI4X0X7BPJ
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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