Chung Shih-Hao, Liu Yen-Yu, Huang Shih-Ya, Sung Meng-Ta, Wu Alice Ying-Jung
Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
Cardiovascular Center, and Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
IDCases. 2024 Jul 18;37:e02031. doi: 10.1016/j.idcr.2024.e02031. eCollection 2024.
Adult haemophagocytic lymphohistiocytosis (HLH) is an infrequent and life-threatening condition. The most common triggers of HLH are malignancy and virus, and bacterial infections are rarely implicated. We present a case of HLH secondary to infection and systemically searched the PubMed database for publications on HLH associated with infection and reviewed nine cases from seven studies. A marked third of patients had infective endocarditis, while the mortality rate was 44 %. HLH developed in our case despite elimination of MRSA from the bloodstream, leading to eventual demise of our patient, suggesting that prolonged hyperimmune response may persist even after the elimination of initial triggering factor. Our case highlights the necessity of high clinical suspicion and prompt diagnosis of HLH.
成人噬血细胞性淋巴组织细胞增生症（HLH）是一种罕见且危及生命的病症。HLH最常见的诱因是恶性肿瘤和病毒，细菌感染很少涉及。我们报告一例继发于感染的HLH病例，并系统检索了PubMed数据库中关于与感染相关的HLH的出版物，回顾了七项研究中的九例病例。显著三分之一的患者患有感染性心内膜炎，死亡率为44%。尽管已从血液中清除耐甲氧西林金黄色葡萄球菌，但我们的病例仍发生了HLH，导致患者最终死亡，这表明即使在消除初始触发因素后，延长的高免疫反应可能仍然持续。我们的病例强调了对HLH进行高度临床怀疑和及时诊断的必要性。
