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Abstract：
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening syndrome for which early recognition and treatment are essential for improving outcomes. HLH is characterized by uncontrolled immune activation leading to fever, cytopenias, hepatosplenomegaly, coagulation abnormalities, and elevated typical markers. This condition can be genetic or secondary, with the latter often triggered by infections. Here, we present a unique case of HLH secondary to acute otitis media (AOM), a common ear infection.
METHODS: We describe a 4-year-old boy who initially presented with a high fever and otalgia, later diagnosed with bilateral AOM. Despite antibiotic treatment, his condition deteriorated.
METHODS: The patient fulfilled diagnostic criteria for HLH.
METHODS: Aggressive treatment by using combination therapy with immunoglobulins, intravenous steroids (dexamethasone), cyclosporine, and etoposide was performed.
RESULTS: After 1 month of treatment, improvement in the otologic symptoms was observed, and hematological findings gradually improved and normalized.
CONCLUSIONS: The link between AOM and HLH may be associated with inflammatory responses and immunological mechanisms, highlighting the importance of considering HLH in severe infection cases. This case emphasizes the need for prompt diagnosis and management, especially in secondary HLH scenarios, to improve patient outcomes. It is imperative to be aware of the potential correlation between these 2 conditions, and healthcare professionals should consider the likelihood of HLH.
METHODS: We describe a 4-year-old boy who initially presented with a high fever and otalgia, later diagnosed with bilateral AOM. Despite antibiotic treatment, his condition deteriorated.
METHODS: The patient fulfilled diagnostic criteria for HLH.
METHODS: Aggressive treatment by using combination therapy with immunoglobulins, intravenous steroids (dexamethasone), cyclosporine, and etoposide was performed.
RESULTS: After 1 month of treatment, improvement in the otologic symptoms was observed, and hematological findings gradually improved and normalized.
CONCLUSIONS: The link between AOM and HLH may be associated with inflammatory responses and immunological mechanisms, highlighting the importance of considering HLH in severe infection cases. This case emphasizes the need for prompt diagnosis and management, especially in secondary HLH scenarios, to improve patient outcomes. It is imperative to be aware of the potential correlation between these 2 conditions, and healthcare professionals should consider the likelihood of HLH.
摘要：
背景：噬血细胞性淋巴组织细胞增生症（HLH）是一种可能危及生命的综合征，早期识别和治疗对于改善预后至关重要。HLH的特点是不受控制的免疫激活导致发烧，血细胞减少,肝脾肿大,凝血异常，和升高的典型标记。这种情况可以是遗传的或继发性的，后者通常由感染引发。这里,我们介绍了急性中耳炎（AOM）继发HLH的独特病例，常见的耳部感染.
方法：我们描述了一个4岁男孩，他最初表现为高烧和耳痛，后来诊断为双侧AOM。尽管有抗生素治疗,他的病情恶化。
方法：患者符合HLH诊断标准。
方法：使用免疫球蛋白联合治疗的积极治疗，静脉注射类固醇（地塞米松），环孢菌素,并进行依托泊苷。
结果：治疗1个月后，观察到耳科症状的改善，血液学检查结果逐渐好转并恢复正常。
结论：AOM和HLH之间的联系可能与炎症反应和免疫机制有关，强调在严重感染病例中考虑HLH的重要性。这种情况强调需要及时诊断和管理，尤其是在继发性HLH情况下，改善患者预后。必须意识到这两个条件之间的潜在相关性，医疗保健专业人员应该考虑HLH的可能性。
方法：我们描述了一个4岁男孩，他最初表现为高烧和耳痛，后来诊断为双侧AOM。尽管有抗生素治疗,他的病情恶化。
方法：患者符合HLH诊断标准。
方法：使用免疫球蛋白联合治疗的积极治疗，静脉注射类固醇（地塞米松），环孢菌素,并进行依托泊苷。
结果：治疗1个月后，观察到耳科症状的改善，血液学检查结果逐渐好转并恢复正常。
结论：AOM和HLH之间的联系可能与炎症反应和免疫机制有关，强调在严重感染病例中考虑HLH的重要性。这种情况强调需要及时诊断和管理，尤其是在继发性HLH情况下，改善患者预后。必须意识到这两个条件之间的潜在相关性，医疗保健专业人员应该考虑HLH的可能性。
