Zhou Xiao, Duan Mei-Li
Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100054, China.
World J Clin Cases. 2021 Aug 6;9(22):6403-6409. doi: 10.12998/wjcc.v9.i22.6403.
Malaria-associated secondary hemophagocytic lymphohistiocytosis (HLH) is rare. Moreover, the literature on malaria-associated HLH is sparse, and there are no similar cases reported in China.
We report the case of a 29-year-old woman with unexplained intermittent fever who was admitted to our hospital due to an unclear diagnosis. The patient concealed her history of travel to Nigeria before onset. We made a diagnosis of malaria-associated secondary HLH. The treatment strategy for this patient included treatment of the inciting factor (artemether for 9 d followed by artemisinin for 5 d), the use of immunosuppressants (steroids, intravenous immunoglobulin) and supportive care. The patient was discharged in normal physical condition after 25 d of intensive care. No relapses were documented on follow-up at six months and 1 year.
Early diagnosis of the primary disease along with timely intervention and a multidisciplinary approach can help patients achieve a satisfactory outcome.
疟疾相关的继发性噬血细胞性淋巴组织细胞增生症(HLH)较为罕见。此外,关于疟疾相关HLH的文献稀少,且中国尚无类似病例报道。
我们报告了一名29岁不明原因间歇性发热女性的病例,该患者因诊断不明入院。患者发病前隐瞒了前往尼日利亚的旅行史。我们诊断为疟疾相关的继发性HLH。该患者的治疗策略包括治疗诱发因素(蒿甲醚治疗9天,随后青蒿素治疗5天)、使用免疫抑制剂(类固醇、静脉注射免疫球蛋白)及支持治疗。经过25天的重症监护,患者身体状况正常出院。随访6个月和1年时均未记录到复发情况。
对原发疾病的早期诊断以及及时干预和多学科方法有助于患者获得满意的治疗效果。