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Incidence and treatment of hemophagocytic lymphohistiocytosis in hospitalized children with Ehrlichia infection
Author(s) -
Cabler Stephanie S.,
Hogan Patrick G.,
Fritz Stephanie A.,
Bednarski Jeffrey J.,
Hunstad David A.
Publication year - 2020
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.28436
Subject(s) - medicine , hemophagocytic lymphohistiocytosis , ehrlichiosis , doxycycline , incidence (geometry) , ehrlichia chaffeensis , pediatrics , chemotherapy , ehrlichia , immunology , antibiotics , virology , disease , physics , optics , microbiology and biotechnology , tick , biology
Abstract We report a large cohort of pediatric patients with human monocytic ehrlichiosis (HME), enabling an estimated incidence of secondary hemophagocytic lymphohistiocytosis (HLH) in hospitalized children with HME. Among 49 children with PCR‐confirmed Ehrlichia infection, 8 (16%) met current criteria for HLH. Those with HLH had more significant hematologic abnormalities and longer durations from symptom onset to admission and definitive anti‐infective therapy. Among these eight, three received chemotherapy plus doxycycline, one of whom died; the other five were treated with doxycycline without chemotherapy, and all survived without HLH recurrence. Our findings demonstrate that antimicrobial therapy alone can successfully resolve Ehrlichia ‐associated HLH.