Hong Jeong Woo, You Hyun Seon, Lee Tae Won, Jo Won Yong, Kim Bo Ra, Suh Young Sun, Bae In Gyu, Cho Oh Hyun
Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Division of Infectious Diseases, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Infect Chemother. 2016 Dec;48(4):330-333. doi: 10.3947/ic.2016.48.4.330. Epub 2016 Nov 8.
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.
曾有少数恙虫病相关噬血细胞综合征（HPS）病例，其中大多数通过使用足量抗生素成功治愈。在此，我们报告1例恙虫病感染后发生的与EB病毒（EBV）相关的HPS病例，该病例使用抗立克次体治疗后病情未改善。一名73岁男性因出现焦痂和血清学检查阳性而被诊断为恙虫病，尽管接受了7天的强力霉素治疗，但仍持续发热，遂转至我院。体格检查和实验室检查数据显示肝脾肿大、双血细胞减少、高铁蛋白血症和低纤维蛋白原血症。骨髓检查显示骨髓细胞增多，伴有噬血细胞现象和组织细胞浸润。采用聚合酶链反应在骨髓抽吸物中检测到EBV。在诊断为HPS后，该患者使用大剂量类固醇治疗成功。
