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 "fever" symptom

22q11.2 deletion syndrome

acute rheumatic fever

alexander disease

allergic bronchopulmonary aspergillosis

canavan disease

carcinoma of the gallbladder

child syndrome

congenital toxoplasmosis

cushing syndrome

cystinuria

dracunculiasis

erdheim-chester disease

esophageal adenocarcinoma

esophageal carcinoma

familial mediterranean fever

focal myositis

hodgkin lymphoma, classical

lamellar ichthyosis

legionellosis

locked-in syndrome

malignant atrophic papulosis

neonatal adrenoleukodystrophy

neuralgic amyotrophy

oculocutaneous albinism

papillon-lefèvre syndrome

pyomyositis

pyruvate dehydrogenase deficiency

scrub typhus

severe combined immunodeficiency

sneddon syndrome

systemic capillary leak syndrome

triple a syndrome

typhoid

waldenström macroglobulinemia

wolf-hirschhorn syndrome

This symptom has already been validated