Hemophagocytic Lymphohistiocytosis Secondary to Cerebral Malaria due to Dual Infection with Plasmodium falciparum and vivax: Precise diagnosis forestalled death.

Ritwik Ghosh; Souvik Dubey

Volume : VIII, Issue : IV, April - 2019

Hemophagocytic Lymphohistiocytosis Secondary to Cerebral Malaria due to Dual Infection with Plasmodium falciparum and vivax: Precise diagnosis forestalled death.

Ritwik Ghosh, Souvik Dubey

Abstract :

Haemophagocytic lymphohistiocytosis (HLH) is a systemic disorder of immune dysregulation which can occur as a primary syndrome (genetic) or arise secondary to infectious, rheumatologic, malignant or metabolic disorders. Primary HLH is mostly recognized in childhood whereas the secondary form has no age bar. Literature on malaria–associated HLH is meager. We report a rare and unusual case of HLH which presented to us with cereal malaria due to co–infection by Plasmodium falciparum and Plasmodium vivax. The bone marrow aspiration and biopsy showed proliferation of histiocytes with engulfed haematopoietic cells, however patient survived with aggressive treatment with antimalarials and Intravenous immunoglobulin (IVIG). Thus, this case report emphasizes the need for consideration of diagnosis of HLH in adult patients so as to provide timely diagnosis and prompt treatment to improve the clinical outcome.