Secondary hemophagocytic lymphohistiocytosis in a child with Leptospira infection: A case report

Abstract

Leptospirosis caused by spirochetes of the genus Leptospira in most patientsresult in very mild illness without jaundice. However, a small portion ofpatients develop various complications due to the involvement of multipleorgan systems. Hemophagocytic lymphohistiocytosis is characterized byprolonged fever, hepatosplenomegaly and cytopenias, hyperferritinemia andhypertriglyceridemias, hyperfibrinogenemia, and hemophagocytosis in bonemarrow, lymph nodes, spleen, or liver. Hemophagocytic lymphohistiocytosisassociated with leptospirosis is a very rare condition and it should beconsidered in patients with multiple organ dysfunctions, together withadequate laboratory findings. It can delay the correct diagnosis of leptospirosisand contribute to an adverse outcome. We present a 13-year-old girl withsecondary hemophagocytic lymphohistiocytosis caused by leptospira infectionand favorable outcome with appropriate antibiotics and corticosteroid therapy