Abstract
Hemophagocytic lymphohistiocytosis syndrome (HPS) is a potentially fatal hyperinflammatory response characterized by a generalized histiocytic proliferation with marked hemophagocytosis in bone marrow [1]. Hemophagocytic syndrome has been associated with genetic mutations, autoimmune diseases, hematological malignancies or infections [2,3]. According to the data from Centre for Disease Control and prevention (CDC) Plasmodium falciparum has been associated with HPS but not the Plasmodium vivax [4-7]. We report a case of hemophagocytic syndrome as a complication of Plasmodium vivax malaria which is a rare presentation according to the data. This patient presented with high grade fever with chills (P. vivax positive), fever however did not respond to anti-malarials. The patient continued to have high grade fever with altered sensorium and deranged liver function with pancytopenia. Since she fulfilled the criteria of (HPS), patient was put on injectable steroids and responded dramatically. Hemophagocytic syndrome is a potentially fatal syndrome and therefore high index suspicion and early treatment is the key to reduce the mortatlity.
Highlights
A 21 years old female presented to the emergency department with high grade intermittent fever associated with chills and headache for last 20 days
According to the data from Centre for Disease Control and prevention (CDC) Plasmodium falciparum has been associated with Hemophagocytic lymphohistiocytosis syndrome (HPS) but not the Plasmodium vivax [4,5,6,7]
We report a case of hemophagocytic syndrome as a complication of Plasmodium vivax malaria which is a rare presentation according to the data
Summary
The patient received injectable artesunate for five days. Despite this the fever did not subside and the patient started deteriorating further. Her sensorium got altered and she was shifted to Intensive care unit. The bone marrow did not reveal any significant abnormality. At this juncture, hematological opinion was taken as haemophagocytic syndrome was suspected. The patient was treated with injectable methyleprednisolone on the depicted lines of treatment of HPS and showed dramatical improvement. In three days treatment with systemic steroids the patient was shifted out of ICU with remarkable improvement clinically and hemodynamically. The patient was discharged after four days with oral steroids in tapering dosages for 6 weeks
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
