Flea-Borne Typhus Causing Hemophagocytic Lymphohistiocytosis: An Autopsy Case

Divya Chandramohan; Moyosore Awobajo; Olivia Fisher; Christopher L. Dayton; Gregory M. Anstead

doi:10.3390/idr15010014

Flea-Borne Typhus Causing Hemophagocytic Lymphohistiocytosis: An Autopsy Case

Divya Chandramohan, Moyosore Awobajo, Olivia Fisher, Christopher L. Dayton, Gregory M. Anstead

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Infection with members of the order Rickettsiales (the genera Rickettsia, Anaplasma, Orientia, and Ehrlichia) is known to cause hemophagocytic lymphohistiocytosis (HLH). The literature is scant on flea-borne typhus (FBT) being implicated in this process. We present a case of autopsy-proven HLH caused by FBT in a 71-year-old diabetic female who was initially suspected of having diabetic ketoacidosis who rapidly suffered decompensated multi-organ failure. Although she was suspected of having FBT and HLH pre-mortem, due to her rapid progression to multi-organ failure, she was transitioned to comfort care by her family five days after admission. A literature search yielded five other cases of HLH secondary to FBT, which are analyzed in this review. The literature on HLH occurring with infection due to other members of the order Rickettsiales is also surveyed.

Original language	English (US)
Pages (from-to)	132-141
Number of pages	10
Journal	Infectious Disease Reports
Volume	15
Issue number	1
DOIs	https://doi.org/10.3390/idr15010014
State	Published - Feb 2023

Keywords

Rickettsia felis
Rickettsia typhi
autopsy
fatal
flea-borne typhus
hemophagocytic lymphohistiocytosis

ASJC Scopus subject areas

Infectious Diseases

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10.3390/idr15010014

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title = "Flea-Borne Typhus Causing Hemophagocytic Lymphohistiocytosis: An Autopsy Case",

abstract = "Infection with members of the order Rickettsiales (the genera Rickettsia, Anaplasma, Orientia, and Ehrlichia) is known to cause hemophagocytic lymphohistiocytosis (HLH). The literature is scant on flea-borne typhus (FBT) being implicated in this process. We present a case of autopsy-proven HLH caused by FBT in a 71-year-old diabetic female who was initially suspected of having diabetic ketoacidosis who rapidly suffered decompensated multi-organ failure. Although she was suspected of having FBT and HLH pre-mortem, due to her rapid progression to multi-organ failure, she was transitioned to comfort care by her family five days after admission. A literature search yielded five other cases of HLH secondary to FBT, which are analyzed in this review. The literature on HLH occurring with infection due to other members of the order Rickettsiales is also surveyed.",

keywords = "Rickettsia felis, Rickettsia typhi, autopsy, fatal, flea-borne typhus, hemophagocytic lymphohistiocytosis",

author = "Divya Chandramohan and Moyosore Awobajo and Olivia Fisher and Dayton, {Christopher L.} and Anstead, {Gregory M.}",

note = "Publisher Copyright: {\textcopyright} 2023 by the authors.",

year = "2023",

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doi = "10.3390/idr15010014",

language = "English (US)",

volume = "15",

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T2 - An Autopsy Case

AU - Chandramohan, Divya

AU - Awobajo, Moyosore

AU - Fisher, Olivia

AU - Dayton, Christopher L.

AU - Anstead, Gregory M.

PY - 2023/2

Y1 - 2023/2

N2 - Infection with members of the order Rickettsiales (the genera Rickettsia, Anaplasma, Orientia, and Ehrlichia) is known to cause hemophagocytic lymphohistiocytosis (HLH). The literature is scant on flea-borne typhus (FBT) being implicated in this process. We present a case of autopsy-proven HLH caused by FBT in a 71-year-old diabetic female who was initially suspected of having diabetic ketoacidosis who rapidly suffered decompensated multi-organ failure. Although she was suspected of having FBT and HLH pre-mortem, due to her rapid progression to multi-organ failure, she was transitioned to comfort care by her family five days after admission. A literature search yielded five other cases of HLH secondary to FBT, which are analyzed in this review. The literature on HLH occurring with infection due to other members of the order Rickettsiales is also surveyed.

AB - Infection with members of the order Rickettsiales (the genera Rickettsia, Anaplasma, Orientia, and Ehrlichia) is known to cause hemophagocytic lymphohistiocytosis (HLH). The literature is scant on flea-borne typhus (FBT) being implicated in this process. We present a case of autopsy-proven HLH caused by FBT in a 71-year-old diabetic female who was initially suspected of having diabetic ketoacidosis who rapidly suffered decompensated multi-organ failure. Although she was suspected of having FBT and HLH pre-mortem, due to her rapid progression to multi-organ failure, she was transitioned to comfort care by her family five days after admission. A literature search yielded five other cases of HLH secondary to FBT, which are analyzed in this review. The literature on HLH occurring with infection due to other members of the order Rickettsiales is also surveyed.

KW - Rickettsia felis

KW - Rickettsia typhi

KW - autopsy

KW - fatal

KW - flea-borne typhus

KW - hemophagocytic lymphohistiocytosis

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SN - 2036-7430

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JO - Infectious Disease Reports

JF - Infectious Disease Reports

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ER -

Flea-Borne Typhus Causing Hemophagocytic Lymphohistiocytosis: An Autopsy Case

Abstract

Keywords

ASJC Scopus subject areas

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