ArticleJournal of advanced research2019
Clinical characteristics and effective treatments of scrub typhus-associated hemophagocytic lymphohistiocytosis in children.
Article in Journal of advanced research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 15 citations in OpenAlex.
- Early management of hemophagocytic lymphohistiocytosis/macrophage activation syndrome: a systematic literature review.EULAR rheumatology open · 2026Review
- High infant mortality, eschar absence, and universal CNS involvement in scrub typhus-associated HLH: a case series and narrative synthesis of 91 pediatric cases.Tropical medicine and health · 2026Article
- The Paucity of Typical Pathology: An Autopsy Series of Typhus Group Rickettsiosis-Associated Hemophagocytic Lymphohistiocytosis.Pathogens (Basel, Switzerland) · 2026Article
- Successful management of scrub typhus-associated hemophagocytic lymphohistiocytosis with doxycycline and immunomodulation: a case report.Frontiers in pediatrics · 2026Article
- Severe paediatric scrub typhus with complications: a case report and literature review.BMC pediatrics · 2025Review
- Recurrent acute appendicitis after recovery from scrub typhus that was associated with hemophagocytic lymphohistiocytosis and other severe complications in children: a case report.Frontiers in medicine · 2025Article
- mNGS helped diagnose scrub typhus-associated HLH in children: a report of two cases.Frontiers in public health · 2024Article
- Congenital scrub typhus: a case report and literature review.Frontiers in pediatrics · 2023Article
- Case report: A case of sepsis caused by rickettsial infection-induced hemophagocytic syndrome.Frontiers in medicine · 2023Article
- Article
- A potential tool for predicting epidemic trends and outbreaks of scrub typhus based on Internet search big data analysis in Yunnan Province, China.Frontiers in public health · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is an uncommon and life-threatening disorder that may rarely complicate the clinical course of Orientia tsutsugamushi disease (scrub typhus). Here, we describe the clinical features, laboratory parameters, management, and outcome of 16 children with scrub typhus-associated HLH. All patients satisfied the HLH-2004 diagnostic criteria. All patients had fever of unknown origin and multisystem damage. Raised hepatic transaminases and abnormalities in routine blood test were observed in all children. Imaging tests showed abnormalities in 10 cases. Six patients were treated with intravenous azithromycin for 5 days, and 10 with intravenous chloramphenicol for 7-10 days because of non-response to 3-day azithromycin treatment. Five patients were treated with intravenous albumin and 3 with intravenous immunoglobulin. Two patients with severe symptoms (shortness of breath, cyanosis) were treated with dexamethasone (0.3 mg/kg/d). Fifteen patients recovered completely after 8-22 days of treatment. One patient died. The occurrence of severe complications draws attention to the need for early diagnosis and effective treatment. Anti-rickettsial antibiotic treatment (azithromycin or chloramphenicol) without the need for chemotherapy may be beneficial in such cases, instead of treatment according to the 2004 HLH protocol.
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