Enteric Fever-Associated Hemophagocytic Lymphohistiocytosis: A Systematic Review of Clinical Characteristics and Outcomes

Author:

Meena Durga Shankar1,Kumar Akhilesh1,Kumar Deepak1,Bohra Gopal Krishana1,Purohit Abhishek2

Affiliation:

1. Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India;

2. Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India

Abstract

ABSTRACT. Enteric fever is a major contributor to rising health care costs in developing countries. Associated disease-related complications and drug resistance further compound this problem. Hemophagocytic lymphohistiocytosis (HLH) is an uncommon complication of enteric fever with high morbidity and mortality. This systematic review aimed to evaluate the clinical characteristics and treatment outcomes in enteric fever-associated HLH syndrome. We searched major electronic databases (PubMed, Google Scholar, and Scopus) to identify the cases of enteric fever associated with HLH from inception until June 2023. Prespecified data regarding clinical presentation, outcomes, and HLH therapy were collected. A total of 53 cases of enteric fever with HLH were included in the final analysis. The mean age of patients was 20 years, and the proportions of female and pediatric patients were 52.8% and 45.3%, respectively. The mean duration of illness was 10.4 days. A total of 39.6% of patients had enteric fever-associated complications; coagulopathy and encephalopathy were the most common (23.1% and 13.5%). The overall mortality rate was 9.4% in HLH. A total of 51% of patients received HLH-specific therapy (corticosteroids in 41.5% and intravenous immunoglobulin in 20.8% of patients). On multivariate analysis, high ferritin levels (≥5,000 ng/mL) were significantly associated with mortality (hazard ratio, 3.01; 95% CI = 0.62–14.12, P = 0.041). Enteric fever with secondary HLH is associated with high mortality. This review reveals the potential role of ferritin in disease prognosis. In cases with significantly elevated ferritin levels, the role of immunosuppressants or combination antibiotics should be explored.

Publisher

American Society of Tropical Medicine and Hygiene

Reference37 articles.

1. The current status of enteric fever diagnostics and implications for disease control;Baker,2017

2. The global burden of typhoid and paratyphoid fevers: A systematic analysis for the Global Burden of Disease Study 2017,2019

3. Case fatality rate of enteric fever in endemic countries: A systematic review and meta-analysis;Pieters,2018

4. Typhoid and paratyphoid fever;Bhan,2005

5. Risk factors for the development of severe typhoid fever in Vietnam;Parry,2014

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