A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS
Background: Visceral leishmaniasis-related hemophagocytic lymphohistiocytosis (VL-HLH) is a secondary hemophagocytic syndrome, which can be life-threatening, caused by leishmania and transmitted by infected sandflies. Rapid and accurate identification of leishmania is crucial for clinical strategies...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-08-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220303635 |
| _version_ | 1811294424140873728 |
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| author | Fang Guo Lei Kang Meixian Xu |
| author_facet | Fang Guo Lei Kang Meixian Xu |
| author_sort | Fang Guo |
| collection | DOAJ |
| description | Background: Visceral leishmaniasis-related hemophagocytic lymphohistiocytosis (VL-HLH) is a secondary hemophagocytic syndrome, which can be life-threatening, caused by leishmania and transmitted by infected sandflies. Rapid and accurate identification of leishmania is crucial for clinical strategies. Case report: Here, we report an infantile infection in a non-epidemic area of China. The infant was a 9.5-month-old girl with fever, pancytopenia and hepatosplenomegaly, which meet the HLH-2004 standard, and the negative gene results exclude congenital HLH. However, chemotherapy is ineffective and is accompanied by severe infection. Fortunately, she is diagnosed with VL-HLH (visceral leishmaniasis-related hemophagocytic lymphohistiocytosis), as leishmania is detected by next-generation meta-genome sequencing (mNGS) and quickly relieved after treatment with libosomal amphotericin B (L-AMB). Conclusion: mNGS can detect leishmania in pediatric HLH, and should be performed as a new detection for VL-HLH, particularly for infants, who may not respond to HLH-2004 regimen. |
| first_indexed | 2024-04-13T05:17:19Z |
| format | Article |
| id | doaj.art-34d4cfef684d48abbf147d03f6a2f2bf |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-04-13T05:17:19Z |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-34d4cfef684d48abbf147d03f6a2f2bf2022-12-22T03:00:51ZengElsevierInternational Journal of Infectious Diseases1201-97122020-08-01972729A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGSFang Guo0Lei Kang1Meixian Xu2Department of Infectious Disease, Hebei Children’s Hospital, Shijiazhuang, Hebei, ChinaDepartment of Pediatric Intensive Care Unit, Hebei Children’s Hospital, Shijiazhuang, Hebei, ChinaDepartment of Pediatric Intensive Care Unit, Hebei Children’s Hospital, Shijiazhuang, Hebei, China; Corresponding author at: Department of Pediatric Intensive Care Unit, Hebei Children’s Hospital, No 133, Jianhua Rd, Shijiazhuang, Hebei050000, China.Background: Visceral leishmaniasis-related hemophagocytic lymphohistiocytosis (VL-HLH) is a secondary hemophagocytic syndrome, which can be life-threatening, caused by leishmania and transmitted by infected sandflies. Rapid and accurate identification of leishmania is crucial for clinical strategies. Case report: Here, we report an infantile infection in a non-epidemic area of China. The infant was a 9.5-month-old girl with fever, pancytopenia and hepatosplenomegaly, which meet the HLH-2004 standard, and the negative gene results exclude congenital HLH. However, chemotherapy is ineffective and is accompanied by severe infection. Fortunately, she is diagnosed with VL-HLH (visceral leishmaniasis-related hemophagocytic lymphohistiocytosis), as leishmania is detected by next-generation meta-genome sequencing (mNGS) and quickly relieved after treatment with libosomal amphotericin B (L-AMB). Conclusion: mNGS can detect leishmania in pediatric HLH, and should be performed as a new detection for VL-HLH, particularly for infants, who may not respond to HLH-2004 regimen.http://www.sciencedirect.com/science/article/pii/S1201971220303635Visceral leishmaniasis-related hemophagocytic lymphohistiocytosisNext-generation meta-genome sequencingBone marrow aspiration |
| spellingShingle | Fang Guo Lei Kang Meixian Xu A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS International Journal of Infectious Diseases Visceral leishmaniasis-related hemophagocytic lymphohistiocytosis Next-generation meta-genome sequencing Bone marrow aspiration |
| title | A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS |
| title_full | A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS |
| title_fullStr | A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS |
| title_full_unstemmed | A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS |
| title_short | A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS |
| title_sort | case of pediatric visceral leishmaniasis related hemophagocytic lymphohistiocytosis diagnosed by mngs |
| topic | Visceral leishmaniasis-related hemophagocytic lymphohistiocytosis Next-generation meta-genome sequencing Bone marrow aspiration |
| url | http://www.sciencedirect.com/science/article/pii/S1201971220303635 |
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