Unusual pancytopenia secondary to haemophagocytosis syndrome in rickettsioses.
We report two patients who presented with a long-lasting febrile illness associated with pancytopenia. Both of them had evidence of hypercellular marrow with haemophagocytosis. They were confirmed as having rickettsial infections by serology and had a rapid haematological recovery with anti-rickettsial antibiotics. We highlight the importance of considering rickettsial infections in patients with such clinical presentations, especially in areas where these infections are endemic or re-emerging. Empirical use of anti-rickettsial antibiotics in such situations could be beneficial, when facilities to diagnose rickettsial diseases are not readily available.
Premaratna
R
R
Department of Medicine, Faculty of Medicine, University of Kelaniya, Sri Lanka. ranjan premaratna@lycos.com
Williams
H S A
HS
Chandrasena
T G A N
TG
Rajapakse
R P V J
RP
Kularatna
S A M
SA
de Silva
H J
HJ
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D005260:Female; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000276:immunology / Q000302:isolation & purification; D010198:Pancytopenia / Q000188:drug therapy / Q000209:etiology*; D012282:Rickettsia Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D020114:Rickettsia conorii / Q000276:immunology / Q000302:isolation & purification; D013577:Syndrome; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial