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Case Reports
. 2018 May;24(5):893-897.
doi: 10.3201/eid2405.171802.

Heartland Virus and Hemophagocytic Lymphohistiocytosis in Immunocompromised Patient, Missouri, USA

Abigail L Carlson, Daniel M Pastula, Amy J Lambert, J Erin Staples, Atis Muehlenbachs, George Turabelidze, Charles S Eby, Jesse Keller, Brian Hess, Richard S Buller, Gregory A Storch, Kathleen Byrnes, Louis Dehner, Nigar Kirmani, F Matthew Kuhlmann
Case Reports

Heartland Virus and Hemophagocytic Lymphohistiocytosis in Immunocompromised Patient, Missouri, USA

Abigail L Carlson et al. Emerg Infect Dis. 2018 May.

Abstract

Heartland virus is a suspected tickborne pathogen in the United States. We describe a case of hemophagocytic lymphohistiocytosis, then death, in an immunosuppressed elderly man in Missouri, USA, who was infected with Heartland virus.

Keywords: Bunyaviridae; Hantaviridae Missouri; Phenuiviridae; Phlebovirus; United States; arbovirus; heartland virus; hemophagocytic lymphohistiocytosis; immunocompromised; viruses.

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Figures

Figure 1
Figure 1
Chronology of selected laboratory findings and therapeutic interventions for immunocompromised patient infected with Heartland virus, Missouri, USA. Gray bars indicate treatments administered. CVVHD, continuous veno-venous hemodialysis; IV, intravenous.
Figure 2
Figure 2
Immunohistochemistry of bone marrow from immunocompromised patient infected with Heartland virus (HRTV), Missouri, USA. Testing of biopsied sample from post–symptom onset day 11 shows extensive positive staining for HRTV antigen, including erythrophagocytosis by an HRTV-antigen–positive cell (arrowhead). Scale bar indicates 20μm.
See this image and copyright information in PMC

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