Chen Y C, Chao T Y, Chin J C
Div of Hematology/Oncology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
Infection. 2000 May-Jun;28(3):178-9. doi: 10.1007/s150100050076.
A patient was admitted to our hospital with fever of unknown origin, lymphadenopathy and moderate anemia. The diagnosis of scrub typhus (tsutsugamushi disease) was established on specific serologic demonstration of antibodies to the cross-reacting proteins OX-K antigen and reaffirmed by successful treatment with doxycycline. The diagnosis of hemophagocytic syndrome (HPS) was made on the cytologic findings of many histiocytes containing phagocytosed blood cells in the marrow aspirate. The hemophagocytosis phenomenon disappeared after the scrub typhus was successfully treated, thus suggesting the relationship between scrub typhus and hemophagocytosis. In a patient with rickettsial diseases including scrub typhus, associated with HPS, it is important to understand the relationship between the two disorders since the prognosis for HPS, if untreated, is very poor.
一名患者因不明原因发热、淋巴结病和中度贫血入住我院。通过对交叉反应蛋白OX-K抗原抗体的特异性血清学检测确诊为恙虫病（丛林斑疹伤寒），并用强力霉素成功治疗再次证实了诊断。根据骨髓穿刺液中许多含有吞噬血细胞的组织细胞的细胞学检查结果诊断为噬血细胞综合征（HPS）。恙虫病成功治疗后，噬血细胞现象消失，提示恙虫病与噬血细胞现象之间的关系。在包括恙虫病在内的立克次体病患者中，若伴有HPS，了解这两种疾病之间的关系很重要，因为未经治疗的HPS预后很差。
