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Epstein-Barr Virus Associated Hemophagocytic Syndrome after Scrub Typhus Infection

机译:斑疹伤寒感染后爱泼斯坦-巴尔病毒相关的噬血细胞综合征

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摘要

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.
机译:少数病例有灌木型斑疹伤寒相关的噬血细胞综合征(HPS),其中大多数已使用适当的抗生素成功治疗。在这里,我们报告了一例洗伤性斑疹伤寒感染后与爱泼斯坦-巴尔病毒(EBV)相关的HPS,但使用抗rick病治疗并没有得到改善。尽管进行了7天的强力霉素治疗,但由于持续发烧,一名因焦而被诊断出患有斑疹伤寒且血清学呈阳性的73岁男性被转移到我们的机构。物理和实验室数据显示肝脾肿大,双血细胞减少症,高铁蛋白血症和低纤维蛋白原血症。骨髓检查(BM)显示高细胞性骨髓有吞噬细胞和组织细胞浸润。使用聚合酶链反应在BM抽吸物中检测到EBV。诊断为HPS后,使用大剂量类固醇成功治疗了该患者。

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