Ducci, F.; Mariotti, F.; Mencarini, J.; Fabbri, C.; Manunta, A.F.; Messeri, D.; Parronchi, P.; Blanc, P.; Bartoloni, A. Hemophagocytic Lymphohistiocytosis and Miliary Tuberculosis in an Apparently Immunocompetent Patient: A Case Report. Infect. Dis. Rep.2024, 16, 763-769.
Ducci, F.; Mariotti, F.; Mencarini, J.; Fabbri, C.; Manunta, A.F.; Messeri, D.; Parronchi, P.; Blanc, P.; Bartoloni, A. Hemophagocytic Lymphohistiocytosis and Miliary Tuberculosis in an Apparently Immunocompetent Patient: A Case Report. Infect. Dis. Rep. 2024, 16, 763-769.
Ducci, F.; Mariotti, F.; Mencarini, J.; Fabbri, C.; Manunta, A.F.; Messeri, D.; Parronchi, P.; Blanc, P.; Bartoloni, A. Hemophagocytic Lymphohistiocytosis and Miliary Tuberculosis in an Apparently Immunocompetent Patient: A Case Report. Infect. Dis. Rep.2024, 16, 763-769.
Ducci, F.; Mariotti, F.; Mencarini, J.; Fabbri, C.; Manunta, A.F.; Messeri, D.; Parronchi, P.; Blanc, P.; Bartoloni, A. Hemophagocytic Lymphohistiocytosis and Miliary Tuberculosis in an Apparently Immunocompetent Patient: A Case Report. Infect. Dis. Rep. 2024, 16, 763-769.
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a serious haematologic condition that can be re-lated to various diseases, including tuberculosis (TB). The patient is a previously healthy 26-years-old man, originally from Western Africa, admitted to hospital for fever and weight loss. Given the results of computed tomography (CT) scan, ocular examination and microbiologic tests, a miliary TB with pulmonary, lymph nodal and ocular involvement was diagnosed. Following introduction of antitubercular treatment (ATT) an increase in inflammation indexes and severe pancytopenia were observed; at this point the patient presented six of eight diagnostic criteria for HLH and the diagnosis of HLH secondary to TB was raised. Therefore, HLH treatment with high dose of dexamethasone was started with a good clinical response. We performed a literature re-view of TB-related HLH, which shows a high mortality rate; ATT is necessary to ensure patient survival to remove the antigenic driver. Our patients developed HLH after initiation of ATT as a paradoxical reaction, that may be linked to the release of antigens due to the bactericidal effect of ATT.
Medicine and Pharmacology, Epidemiology and Infectious Diseases
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