Choi Young Bae, Yi Dae Yong
Department of Pediatrics, Chungbuk National University Hospital, Cheongju.
Department of Pediatrics, Chung-Ang University Hospital, Seoul, Republic of Korea.
Medicine (Baltimore). 2018 Oct;97(40):e12210. doi: 10.1097/MD.0000000000012210.
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease characterized by an excessive systemic inflammatory response. HLH is classified as primary or secondary, where the latter may occur in association with many infections. However, no case of HLH has been previously associated with group b streptococcus (GBS) sepsis.
We present a fatal case of HLH in a 5-year-old girl with GBS sepsis.
The present patient met 5 of the HLH criteria: fever, splenomegaly, bicytopenia, hypertriglyceridemia and/or hypofibrinogenemia, and hyperferritinemia. GBS was identified in 2 sets of peripheral blood bacterial cultures.
Empirical antibiotics, inotropes, and immunoglobulins were administered.
The clinical course of the patient was fulminant and the patient died of septic shock 10 hours after admission to the hospital.
We suggest GBS infection can cause HLH and early awareness of HLH associated with GBS infection and proper effective treatment are necessary to reduce mortality.
噬血细胞性淋巴组织细胞增生症（HLH）是一种以全身性过度炎症反应为特征的危及生命的疾病。HLH分为原发性或继发性，后者可能与多种感染相关。然而，此前尚无HLH病例与B组链球菌（GBS）败血症相关的报道。
我们报告了一名5岁患GBS败血症女童的致命性HLH病例。
该患者符合HLH的5项标准：发热、脾肿大、双血细胞减少、高甘油三酯血症和/或低纤维蛋白原血症以及高铁蛋白血症。在两组外周血细菌培养中均鉴定出GBS。
给予经验性抗生素、血管活性药物和免疫球蛋白。
患者临床过程凶险，入院10小时后死于感染性休克。
我们认为GBS感染可导致HLH，早期认识与GBS感染相关的HLH并进行适当有效的治疗对于降低死亡率很有必要。
