title: Scrub typhus-associated severe hemophagocytic lymphohistiocytosis with encephalomyelitis leading to permanent sequelae: a case report and review of the literature.
abstract: Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal disorder. There have been a few reports on HLH secondary to scrub typhus in adults. Here, we describe the case of a 9-year-old Korean girl who presented with the typical findings of HLH. Despite adequate antirickettsial and HLH treatment, the neurological impairment worsened and remained. This is the first case report of severe neurological impairment resulting from the very rare association of HLH with scrub typhus. Therefore, in endemic areas, a high index of suspicion for scrub typhus is warranted in patients presenting with HLH.
authors.affiliation: Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Chollanamdo, Korea.
authors.forename: Dong Kyun
authors.initials: DK
authors.lastname: Han
authors.forename: Hee Jo
authors.initials: HJ
authors.lastname: Baek
authors.forename: Myung-Geun
authors.initials: MG
authors.lastname: Shin
authors.forename: Jin Woong
authors.initials: JW
authors.lastname: Kim
authors.forename: Hoon
authors.initials: H
authors.lastname: Kook
authors.forename: Tai Ju
authors.initials: TJ
authors.lastname: Hwang
mesh_terms: D002648:Child; D004679:Encephalomyelitis / Q000209:etiology*; D005260:Female; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology*; D012612:Scrub Typhus / Q000150:complications*