title: Unusual pancytopenia secondary to haemophagocytosis syndrome in rickettsioses.
abstract: 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.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Kelaniya, Sri Lanka. ranjan premaratna@lycos.com
authors.forename: R
authors.initials: R
authors.lastname: Premaratna
authors.forename: H S A
authors.initials: HS
authors.lastname: Williams
authors.forename: T G A N
authors.initials: TG
authors.lastname: Chandrasena
authors.forename: R P V J
authors.initials: RP
authors.lastname: Rajapakse
authors.forename: S A M
authors.initials: SA
authors.lastname: Kularatna
authors.forename: H J
authors.initials: HJ
authors.lastname: de Silva
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial