{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:16:27Z","timestamp":1790745387956,"version":"4.1.0"},"reference-count":3,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Hemophagocytic lymphohistiocytosis (HLH) is a multisystem disease wherein there is an exaggerated immune system activation following a trigger such as infection, malignancy, or autoimmune diseases. Here we report a case of a 3-year-old boy who presented to us with fever, was diagnosed with dengue fever, and treatment started for the same. Clinical response was poor to treatment and high-grade fever persisted. Subsequent evaluation showed <jats:italic toggle=\"yes\">Plasmodium falciparum<\/jats:italic> malaria and treatment was initiated with antimalarial drugs. Further clinical deterioration with poor trend of laboratory values over the next few days prompted evaluation for HLH; workup was positive satisfying the HLH-2004 criteria and IV dexamethasone was started. The child gradually improved and was discharged with normal counts on follow-up over the next 3 months. This article emphasizes on the importance of high degree of suspicion, early workup, and initiation of treatment for HLH for a better outcome.<\/jats:p>","DOI":"10.1097\/mph.0000000000002018","type":"journal-article","created":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T02:01:10Z","timestamp":1607652070000},"page":"e253-e254","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Dengue and Plasmodium falciparum Coinfection With Secondary Hemophagocytic Lymphohistiocytosis in a 3-Year-old Boy: A Clinical Conundrum"],"prefix":"10.1097","volume":"44","author":[{"given":"Sathya","family":"Srivatsav","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soundarya","family":"Mahalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pardha","family":"Ramineni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharath","family":"Manya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,12,9]]},"reference":[{"key":"R1-20250804","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1007\/s12098-019-03040-0","article-title":"Severe dengue and associated hemophagocytic lymphohistiocytosis in PICU","volume":"86","author":"Bhattacharya","year":"2019","journal-title":"Indian J Pediatr"},{"key":"R3-20250804","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1186\/s12889-019-7488-4","article-title":"Prevalence and laboratory analysis of malaria and dengue co-infection: a systematic review and meta-analysis","volume":"19","author":"Kotepui","year":"2019","journal-title":"BMC Public Health"},{"key":"R4-20250804","doi-asserted-by":"crossref","first-page":"696842","DOI":"10.1155\/2015\/696842","article-title":"Hemophagocytic lymphohistiocytosis complicating dengue and Plasmodium vivax coinfection","volume":"2015","author":"Khurram","year":"2015","journal-title":"Case Rep Med"}],"container-title":["Journal of Pediatric Hematology\/Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MPH.0000000000002018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T20:13:49Z","timestamp":1754338429000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MPH.0000000000002018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,9]]},"references-count":3,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/mph.0000000000002018","relation":{},"ISSN":["1077-4114"],"issn-type":[{"value":"1077-4114","type":"print"}],"subject":[],"published":{"date-parts":[[2020,12,9]]},"assertion":[{"value":"2020-07-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-24","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}