title: Severe Plasmodium vivax cerebral malaria complicated by hemophagocytic lymphohistiocytosis treated with artesunate and doxycycline.
abstract: Malaria-related hemophagocytic lymphohistiocytosis is a rare, potentially fatal, hyperinflammatory disease entity which can be challenging to diagnose and treat. It is usually associated with Plasmodium falciparum infection. It is less frequently associated with Plasmodium vivax. Here we report an unusual case of a 23-year-old healthy Nigerian man who presented with fever, microangiopathic hemolytic anemia, acute renal failure, and confusion, and was diagnosed as having cerebral malaria-related hemophagocytic lymphohistiocytosis caused by P. vivax infection. He was successfully treated with intravenous artesunate and doxycycline with dramatic clinical improvement.
authors: Internal Medicine Department and Department of Hematology and Oncology, Saint Michael's Medical Center, Newark, NJ, USA.
authors: Sawsan
authors: S
authors: Amireh
authors: Internal Medicine Department and Department of Hematology and Oncology, Saint Michael's Medical Center, Newark, NJ, USA. Electronic address: hamidshaaban@gmail.com.
authors: Hamid
authors: H
authors: Shaaban
authors: Internal Medicine Department and Department of Hematology and Oncology, Saint Michael's Medical Center, Newark, NJ, USA.
authors: Gunwant
authors: G
authors: Guron
mesh_terms: D000328:Adult; D037621:Artemisinins / Q000008:administration & dosage*; D000077332:Artesunate; D004318:Doxycycline / Q000008:administration & dosage*; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016779:Malaria, Cerebral / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016780:Malaria, Vivax / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D010966:Plasmodium vivax
chemical_list: D037621:Artemisinins; D000077332:Artesunate; D004318:Doxycycline
keywords: Artesunate; Doxycycline; Hemophagocytic lymphohistiocytosis; Malaria; Plasmodium vivax