Ehrlichia-induced hemophagocytic lymphohistiocytosis in a pediatric kidney transplant recipient.
BACKGROUND: Kidney transplant patients are susceptible to a variety of infections in the post-transplant period due to the use of immunosuppressant medications. Ehrlichiosis is a rare infection in solid organ transplant recipients with signs and symptoms that mimic rejection and other viral infections. Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal hyperinflammatory syndrome that can be triggered by infections.
METHODS: We describe a pediatric kidney transplant recipient who experienced secondary HLH due to ehrlichiosis within the initial post-transplant month.
RESULT: Our patient improved after treatment with doxycycline, corticosteroids, and intravenous immunoglobulin (IVIG).
CONCLUSION: Clinicians should consider infections such as ehrlichiosis as a potential cause of illness in febrile solid organ transplant recipients in immediate post-transplant period, especially when accompanied by a compatible exposure history.
ehrlichiosis; fever; hemophagocytic lymphohistiocytosis; kidney transplant
Singh NS, Pagano AL, Hays AJ, et al. Ehrlichia-induced hemophagocytic lymphohistiocytosis in a pediatric kidney transplant recipient. Pediatr Transplant. 2022;26(1):e14134. doi:10.1111/petr.14134