Loading...
Dengue is endemic in the tropics; in 2010, an estimated 390 million infections occurred worldwide. Mosquitoes that transmit dengue virus (DENV) are common in many U.S. states, and local outbreaks have occurred in Florida, Hawaii, and Texas. Hemophagocytic lymphohistiocytosis (HLH) — a potentially fatal hyperinflammatory syndrome characterized by persistent fever, pancytopenia, hepatosplenomegaly, and increased ferritin levels — can be triggered by DENV infection. Immunosuppressed individuals are at increased risk for this complication and, if they develop it, for higher severity and mortality.
On September 2, 2012, a 63-year-old Texas woman with recent travel only to Santa Fe, New Mexico, presented with fatigue, anorexia, headache, hematuria…