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 "seizures" symptom

alexander disease

alpha-thalassemia

cadasil

canavan disease

child syndrome

classical phenylketonuria

coats disease

cohen syndrome

cowden syndrome

erdheim-chester disease

familial hypocalciuric hypercalcemia

familial mediterranean fever

gm1 gangliosidosis

hirschsprung disease

homocystinuria without methylmalonic aciduria

kabuki syndrome

kallmann syndrome

krabbe disease

lamellar ichthyosis

legionellosis

locked-in syndrome

lymphangioleiomyomatosis

malignant atrophic papulosis

monosomy 21

neonatal adrenoleukodystrophy

oligodontia

phenylketonuria

proteus syndrome

pyruvate dehydrogenase deficiency

scrub typhus

sneddon syndrome

wolf-hirschhorn syndrome

x-linked adrenoleukodystrophy

zellweger syndrome

This symptom has already been validated