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Triple trouble--macrophage activation syndrome in a case of severe leptospirosis and scrub typhus co-infection.
[scrub typhus]
Macrophage
activation
syndrome
is
a
potentially
life
threatening
phenomenon
characterised
by
aggressive
proliferation
of
macrophages
and
T
lymphocytes
leading
to
haemophagocytosis
of
other
blood
cells
and
multi
organ
failure
.
Here
we
present
a
very
unusual
combination
of
leptospirosis
and
scrub
typhus
infection
leading
to
macrophage
activation
syndrome
.
Scrub
typhus
associated
with
macrophage
activation
syndrome
has
rarely
been
reported
in
India
.
A
40
year
old
female
presented
with
high
grade
fever
,
seizures
,
bodyache
,
arthralgia
and
severe
breathlessness
.
Investigations
revealed
persistent
thrombocytopenia
,
impaired
liver
function
tests
,
renal
dysfunction
,
leptospiral
IgM
ELISA
positive
and
a
positive
Weil
Felix
test
.
There
was
evidence
of
haemophagocytosis
in
bone
marrow
.
Macrophage
activation
syndrome
if
left
untreated
has
been
associated
with
rapidly
fatal
outcome
and
early
treatment
can
help
us
save
that
one
precious
thing
.
.
called
life
.
.
!
Diseases
Validation
Diseases presenting
"potentially life"
symptom
epidermolysis bullosa simplex
harlequin ichthyosis
lymphangioleiomyomatosis
pyomyositis
scrub typhus
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