EJMCR |

Case Report

Volume: 4 | Issue: 2 | Published: Feb 19, 2020 | Pages: 75 - 78 | DOI: 10.24911/ejmcr/173-1574044842

Typhoid fever with hemophagocytic lymphohistiocytosis masquerading as dengue fever: a case report

Authors: Wong Ji Yin , Poh Kok Wei , Wong Poh Shean , Nik Hafidzah , Sharifah Suryani , Cheah Chee Ken , Ng Tiang Koi

Article Info

Authors

Wong Ji Yin

Medical Department, Hospital Tuanku Ja&apos;afar Seremban, Malaysia

Poh Kok Wei

Medical Department, Hospital Tuanku Ja&apos;afar Seremban, Malaysia

Wong Poh Shean

Medical Department, Hospital Tuanku Ja&apos;afar Seremban, Malaysia

Nik Hafidzah

Pathology Department, Hospital Tuanku Ja&apos;afar Seremban, Malaysia

Sharifah Suryani

Medical Department, Hospital Tuanku Ja&apos;afar Seremban, Malaysia

Cheah Chee Ken

Medical Department, Hospital Tuanku Ja&apos;afar Seremban, Malaysia

Ng Tiang Koi

Medical Department, Hospital Tuanku Ja&apos;afar Seremban, Malaysia

Publication History

Received: November 18, 2019

Revised: January 12, 2020

Accepted: February 08, 2020

Published: February 19, 2020

Abstract

Background: Dengue fever classically presents with fever, arthralgia, myalgia, leukopenia, and thrombocytopenia. A classical presentation with a positive serology test is usually enough to make the diagnosis in an endemic area. Case Presentation: A 30-year-old man presented with fever, leucopenia, thrombocytopenia, hepatitis, and delirium. Dengue Immunoglobulin M (IgM) serology was positive. Blood culture grew Salmonella typhi, his ferritin was raised, and bone marrow histology showed histiocytes and hemophagocytic activity. A 2-week course of ceftriaxone (60-75 mg/kg/day) and intravenous immunoglobulin (0.4 g/kg once a day) for 3 days resulted in complete resolution of his illness. Conclusion: We report a case of typhoid fever with hemophagocytic lymphohistiocytosis mimicking as dengue fever due to cytopenias and hepatitis, and dengue IgM serology was positive. Although rare, a high index of suspicion is required for early diagnosis and treatment.

Keywords: Dengue fever, typhoid, hemophagocytic lymphohistiocytosis, HLH, case report, green

Pubmed Style

Wong Ji Yin, Poh Kok Wei, Wong Poh Shean, Nik Hafidzah, Sharifah Suryani, Cheah Chee Ken, Ng Tiang Koi. Typhoid fever with hemophagocytic lymphohistiocytosis masquerading as dengue fever: a case report. EJMCR. 2020; 19 (February 2020): 75-78. doi:10.24911/ejmcr/173-1574044842

Web Style

Wong Ji Yin, Poh Kok Wei, Wong Poh Shean, Nik Hafidzah, Sharifah Suryani, Cheah Chee Ken, Ng Tiang Koi. Typhoid fever with hemophagocytic lymphohistiocytosis masquerading as dengue fever: a case report. https://ejmcr.com/articles/1457 [Access: November 23, 2024]. doi:10.24911/ejmcr/173-1574044842

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Wong Ji Yin, Poh Kok Wei, Wong Poh Shean, Nik Hafidzah, Sharifah Suryani, Cheah Chee Ken, Ng Tiang Koi. Typhoid fever with hemophagocytic lymphohistiocytosis masquerading as dengue fever: a case report. EJMCR. (2020), [cited November 23, 2024]; 19 (February 2020): 75-78. doi:10.24911/ejmcr/173-1574044842

Harvard Style

Wong Ji Yin, Poh Kok Wei, Wong Poh Shean, Nik Hafidzah, Sharifah Suryani, Cheah Chee Ken, Ng Tiang Koi (2020) Typhoid fever with hemophagocytic lymphohistiocytosis masquerading as dengue fever: a case report. EJMCR, 19 (February 2020): 75-78. doi:10.24911/ejmcr/173-1574044842

Chicago Style

Wong Ji Yin, Poh Kok Wei, Wong Poh Shean, Nik Hafidzah, Sharifah Suryani, Cheah Chee Ken, Ng Tiang Koi. "Typhoid fever with hemophagocytic lymphohistiocytosis masquerading as dengue fever: a case report." 19 (2020), 75-78. doi:10.24911/ejmcr/173-1574044842

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Wong Ji Yin, Poh Kok Wei, Wong Poh Shean, Nik Hafidzah, Sharifah Suryani, Cheah Chee Ken, Ng Tiang Koi (2020) Typhoid fever with hemophagocytic lymphohistiocytosis masquerading as dengue fever: a case report. , 19 (February 2020), 75-78. doi:10.24911/ejmcr/173-1574044842