Ramamoorthy Lakshiya, Sivakumar Nithila, Murugesan Lakshmi, Kumar Arul
Internal Medicine, Madras Medical College, Chennai, IND.
Pediatric Medicine, Government Tiruppur Medical College and Hospital, Tiruppur, IND.
Cureus. 2024 Apr 27;16(4):e59165. doi: 10.7759/cureus.59165. eCollection 2024 Apr.
Dengue fever, an arboviral illness, exhibits a broad range of symptoms, ranging from flu-like symptoms to serious hemorrhagic complications. Hemophagocytic lymphohistiocytosis (HLH) is an uncommon pathological state caused by excessive activation of the immune system, culminating in organ dysfunction. HLH can be primary or secondary, with infection being the most common cause. The association between dengue fever and dengue-induced HLH is becoming widely acknowledged as a lethal complication. We present the case of a two-year-old male child referred for the management of dengue infection. The patient's condition failed to ameliorate despite appropriate treatment. On further investigation, he was diagnosed with HLH. Following the initiation of steroid therapy, the patient demonstrated gradual improvement with normalization of laboratory parameters. Differentiating between HLH and severe dengue hemorrhagic fever poses a significant challenge, emphasizing the importance of prompt diagnosis for favorable outcomes. Early identification and commencement of corticosteroid therapy are imperative for successful management.
登革热是一种虫媒病毒疾病,症状范围广泛,从类似流感的症状到严重的出血并发症。噬血细胞性淋巴组织细胞增生症(HLH)是一种由免疫系统过度激活引起的罕见病理状态,最终导致器官功能障碍。HLH可分为原发性或继发性,感染是最常见的原因。登革热与登革热诱发的HLH之间的关联正被广泛认为是一种致命并发症。我们报告一例因登革热感染前来就诊的两岁男童病例。尽管进行了适当治疗,患者的病情仍未改善。进一步检查后,他被诊断为HLH。开始使用类固醇治疗后,患者病情逐渐改善,实验室指标恢复正常。区分HLH和严重登革出血热是一项重大挑战,这凸显了及时诊断对于取得良好预后的重要性。早期识别并开始使用皮质类固醇治疗对于成功治疗至关重要。