[Adult-hlh-mas] Possible HLH Case Parkland [securemail]

Dheepa Sekar DHEEPA.SEKAR at phhs.org
Sun Aug 5 15:07:46 CDT 2018

Parkland Patient

Alpha, U (no name given on admission and patient somewhat disoriented. Family now here and involved in care)

MRN: 5027945

36 yo Honduran man presented with 1 month of fatigue and night sweats. No prior known medical history, found to have HIV and disseminated histo on this admission. Course has rapidly progressed, now intubated with ARDS and in septic shock on escalating pressor requirement.  Currently on amphotericin for histo as well as RIPE (pending AFB smears) and Bactrim IV for possible PCP. Also with +RPR and treating for secondary syphilis (macules on palms).

Workup thus far:

ferritin >42,000

thrombocytopenia (20, no other signs of hemolysis), anemia

TG 121

Other workup:

HIV +, CD4 13. histo ag positive. fungal comp fix pending. fungal culture pending.

MTB CPR neg. AFB 2/3 neg

Dheepa Sekar

PGY3 Internal Medicine

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