A Rare Case of Disseminated Histoplasmosis Presenting with Hemophagocytic Lymphohistiocytosis

Abstract

ABSTRACT Hemophagocytic lymphohistiocytosis (HLH) encompasses a wide spectrum of causes, characterized by excessive immune system activation and release of a cascade of inflammatory markers. HLH can be familial or primary and secondary, secondary being more common. Secondary HLH holds primary concern as it involves treatable causes and hence timely diagnosis and appropriate treatment are of utmost importance in patient care. Our case report is of a 34-year-old immunocompetent male with a history of fever of 5 days duration along with breathlessness, myalgia, and cough at the onset, but the symptoms kept deteriorating over a period of 1.5 months. Due to the wide range of clinical presentations and overlap of symptoms, an array of differentials was considered, however prioritizing an infectious cause led to our final diagnosis in this case. The patient succumbed to the disease.