A case of haemophagocytic syndrome in HIV-associated disseminated histoplasmosis

A case of haemophagocytic syndrome in HIV-associated disseminated histoplasmosis

Abstract

Disseminated histoplasmosis is an opportunistic infection which is commonly associated with HIV. Haemophagocytic lymphohistiocytosis (HLH) has been described as a secondary phenomenon to infection, collagen – vascular disorders and malignancies. In patients with HIV, cases of reactive haemophagocytic syndrome associated with disseminated histoplasmosis have been reported with CD4 counts of less than 50 cells/μl (450-1660 cells/μl). We report a case of a 25 year old man with HIV who presented with a CD4 count of 153 cells/μl and would suggest that this diagnosis should be considered at higher CD4 counts than previously reported.

[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]

References

  1. Scott R, Robb-Smith A. Histiocytic medullary reticulosis. Lancet 1939; 2: 194-8.
  2. Risdall RJ, McKenna RW, Nesbit ME, et al. Virus-associated hemophagocytic syndrome: a benign histiocytic proliferation distinct from malignant histiocytosis. Cancer 1979; 44(3): 993-1002.
  3. Rouphael NG, Talati NJ, Vaughan C, et al. Infections associated with haemophagocytic syndrome. Lancet Infect Dis 2007; 7(12): 814-22.
  4. Grateau G, Bachmeyer C, Blanche P, et al. Haemophagocytic syndrome in patients infected with the human immunodeficiency virus: nine cases and a review. J Infect 1997; 34(3): 219-25.
  5. Kaito K, Kobayashi M, Katayama T, et al. Prognostic factors of hemophagocytic syndrome in adults: analysis of 34 cases. Eur J Haematol 1997; 59(4): 247-53.
  6. Janka G, Imashuku S, Elinder G, et al. Infection- and malignancyassociated hemophagocytic syndromes. Secondary hemophagocytic lymphohistiocytosis. Hematol Oncol Clin North Am 1998; 12(2): 435-44.
  7. Bouffandeau B, Mofredj A, Blanc S. Hemophagocytic syndrome in the critically ill. Intensive Care Med 2001; 27(5): 948-9.
  8. Henter JI, Elinder G, Ost A. Diagnostic guidelines for hemophagocytic lymphohistiocytosis. The FHL Study Group of the Histiocyte Society. Semin Oncol 1991; 18(1): 29-33.
  9. Sanchez A, Celaya AK, Victorio A. Histoplasmosis-associated hemophagocytic syndrome: a case report. AIDS Read 2007; 17(10): 496-9.
  10. Pellegrin JL, Merlio JP, Lacoste D, et al. Syndrome of macrophagic activation with hemophagocytosis in human immunodeficiency virus infection. Rev Med Interne 1992; 13(6): 438-40.
  11. Pontes J, Mateo O, Gaspar G, et al. Hemophagocytosis syndrome associated with acute HIV infection. Enferm Infecc Microbiol Clin 1995; 13(7): 441-2.
  12. Chen TL, Wong WW, Chiou TJ. Hemophagocytic syndrome: an unusual manifestation of acute human immunodeficiency virus infection. Int J Hematol 2003; 78(5): 450-2.
  13. Sun HY, Chen MY, Fang CT, et al. Hemophagocytic lymphohistiocytosis: an unusual initial presentation of acute HIV infection. J Acquir Immune Defic Syndr 2004; 37(4): 1539-40.
  14. Hajjeh RA, Pappas PG, Henderson H, et al. Multicenter case-control study of risk factors for histoplasmosis in human immunodeficiency virusinfected persons. Clin Infect Dis 2001; 32(8): 1215-20.
  15. McKinsey DS, Spiegel RA, Hutwagner L, et al. Prospective study of histoplasmosis in patients infected with human immunodeficiency virus: incidence, risk factors, and pathophysiology. Clin Infect Dis 1997; 24(6): 1195-203.
  16. Wheat LJ, Chetchotisakd P, Williams B, et al. Factors associated with severe manifestations of histoplasmosis in AIDS. Clin Infect Dis 2000; 30(6): 877-81.

Request Permissions

To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:

Get Permission

A case of haemophagocytic syndrome in HIV-associated disseminated histoplasmosis

10th March 2016
PMID: 21904709
Authors Affiliations
Nidhi Vaid MSc, MBBS, MRCP, DTMH Specialist registrar in Acute medicine, Chelsea and Westminster Hospital, London
Parind Patel MBBS, FRCA Consultant in Intensive Care, Hammersmith Hospital, London

A case of haemophagocytic syndrome in HIV-associated disseminated histoplasmosis

Cite this article as:

Vaid N, Patel P. A case of haemophagocytic syndrome in HIV-associated disseminated histoplasmosis. Acute Med. 2011;10(3):142-4. PMID: 21904709.

A case of haemophagocytic syndrome in HIV-associated disseminated histoplasmosis

Share this article

Click the icon of the social media platform on which you would like to share this article.


Shopping Basket
Scroll to Top