Successful management of Lassa fever disease in a Nigerian with haemoglobin SC disease at the Lassa fever management centre of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria
Keywords:
Case report, Haemoglobin SC, Lassa fever disease, sickle cell disease, NigeriaAbstract
Background: Sickle cell disease (SCD) is a group of inherited blood disorders resulting from the presence of mutated form of haemoglobin, known as haemoglobin S (HbS). Inheritance of abnormal HbS can occur in homozygous form (HbSS), called sickle cell anaemia or in combination with other haemoglobin variant such as HbSC. There is paucity of study on the management of Lassa fever disease in patients with sickle cell disease. The objective of this study is to report a successfully managed case of Lassa fever disease in an adult with sickle cell disease (HbSC).
Case presentation: We report a 25year old man living with sickle cell disease (HbSC), who presented to the Alex Ekwueme Federal University Teaching Hospital Abakaliki, with complaint of fever, malaise, weakness of 6 days and abdominal pain, passage of watery stool, nausea, vomiting and generalised joint pain 2 days prior to presentation. Following physical examination, a provisional diagnosed of vaso-occlusive crisis with gastroenteritis with background malaria was made. Worsening of symptoms despite treatment with antimalarial, antibiotics and analgesics, led to the suspicion of Lassa fever which was confirmed with polymerase chain reaction (PCR). Patient was then treated with ribavirin, recovered completely with no residual complication and was subsequently discharged.
Conclusion: This case illustrates the importance of having high index of suspicion following persistent fever with non-response to treatment. Death due to Lassa fever disease can be prevented by early presentation to the hospital, high index of suspicion and close monitoring, avoiding delays to commencement of treatment.
References
Pecker LH, Hoppe C, Little JA. Sickle Cell Disease and the Haemoglobinopathies. In: Lazarus HM, Schmaier AH (editors). Concise guide to Haematology. 2ndedition. Switzerland Springer 2019; 49-58.
Isa HA, Adegoke SA, Madu AJ, Abdul-Aziz H, Ohiaeri CN, Chianumba R, et al. Sickle Cell Disease Clinical Phenotypes in Nigeria: A preliminary analysis of the Sickle pan Africa Research consortium (SPARCO) Nigeria Database. Blood cells, Molecules and Diseases 2020; 84: 102438.
Ugwu NI, Nna EO, Ugwu CN, Onwe EO, Okike C, Ikeagwulonu RC, et al. Evaluation of Fetal Haemoglobin status among Nigerian patients with sickle cell anaemia using High Performance Liquid Chromatography. West African Journal of Medicine 2021; 38(3): 222 -227.
Balogun OO, Akande OW, Hamer DH. Lassa Fever: An evolving emergency in West Africa. Am. J. Trop. Med. Hyg. 2021, 104(2): 466 –473.
Abdullahi IN, Anka AU, Ghamba PE, Onukegbe NB, Amadu DO, Salami MO. Need for preventive and control measures for Lassa fever through the One Health strategic approach.Proceedings of Singapore Healthcare. 2020; 29(3): 190 -194.
Thielebein A, Ighodalo Y, Taju A, Olokor T, Omiunu R, Esumeh R, et al. Virus persistence after recovery from acute Lassa fever in Nigeria: a 2-year interim analysis of a prospective longitudinal cohort study. The Lancet microbe 2022; 3(1): e32 –e40.
Ajayi NA, Ukwaja KN, Ifebunandu NA, Nnabu R, Onwe FI, Asogun DA. Lassa fever -full recovery without ribavarin treatment: a case report. Afr Health Sci. 2014; 14(4): 1074 -1077.
Adewuyi GM, Fowotade A, Adewuyi BT. Lassa Fever: another infectious menace. African Journal of Clinical and Experimental Microbiology 2009; 10(3): 144 –155.
Ilori EA, Furuse Y, Ipadeola OB, Dan-Nwafor CC, Abubakar A, Womi-Eteng OE, et al.Epidemiologic and Clinical Features of Lassa Fever outbreak in Nigeria, January 1-May 6, 2018. Emerg Infect Dis. 2019; 25(6): 1066-1074.
Ficenec SC, Percak J, Arguello S, Bays A, Goba A, Gbakie M, et al. Lassa fever-induced hearing loss: The neglected disability of haemorrhagic fever. Int J Infect Dis 2020; 100: 32 –37.
Ajayi NA, Nwigwe CG, Azuogu BN, Onyire BN, Nwonwu EU, Ogbonnaya LU, et al. Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki, Nigeria (January-March 2012). Int J Infect Dis. 2013; 17(11): e1011 –e1016.
Gong L, Parikh S, Rosenthal PJ, Greenhouse B. Biochemical and immunological mechanisms by which sickle cell trait protects against malaria. Malar J. 2013; 12: 317.
Russmann S, Grattagliano I, Portincasa P, Palmieri V, Palasciano G. Ribavirin-Induced Anemia: Mechanisms, Risk Factors and Related Targets for Future Research. Current Medicinal Chemistry 2006; 13: 3351-3357.
Owhin SO, Abejegah C, Olatunde LO, Akhideno PE, Emorinken A, Yusuf A, et al. The Impact and Morphology of Anaemia among Lassa Fever Patients Treated in a Dedicated Treatment Centre in South West Nigeria. J Trop Med Health 2020; 4: 148.
Marengo-Rowe AJ. Structure-function relations of human hemoglobins. Proc (Bayl Univ Med Cent). 2006; 19(3): 239 -245.
Ilesanmi O, Ayodeji O, Adedosu N, Ojo O, Abejegah C, Jegede T, et al. Mortality among confirmed Lassa Fever cases in Ondo State, Nigeria, January 2017-March 2019: A cross sectional study. Journal of Community Health Research2022; 11(1): 5 –11.
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