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Scrub Typhus-associated Severe Hemophagocytic Lymphohistiocytosis With Encephalomyelitis Leading to Permanent Sequelae: A Case Report and Review of the Literature

Han, Dong Kyun MD; Baek, Hee Jo MD; Shin, Myung-Geun MD, PhD; Kim, Jin Woong MD, PhD; Kook, Hoon MD, PhD; Hwang, Tai Ju MD, PhD

Journal of Pediatric Hematology/Oncology: October 2012 - Volume 34 - Issue 7 - p 531–533
doi: 10.1097/MPH.0b013e318257a442
Clinical and Laboratory Observations

Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal disorder. There have been a few reports on HLH secondary to scrub typhus in adults. Here, we describe the case of a 9-year-old Korean girl who presented with the typical findings of HLH. Despite adequate antirickettsial and HLH treatment, the neurological impairment worsened and remained. This is the first case report of severe neurological impairment resulting from the very rare association of HLH with scrub typhus. Therefore, in endemic areas, a high index of suspicion for scrub typhus is warranted in patients presenting with HLH.

Departments of *Pediatrics

Laboratory Medicine

Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Chollanamdo, Korea

The authors declare no conflict of interest.

Reprints: Hoon Kook, MD, PhD, Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160 Ilsim-Ri, Hwasun-Gun, Gwangju, Chollanamdo 519-809, Korea (South) (e-mail:

Received July 20, 2011

Accepted March 27, 2012

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.