Hemophagocytic Lymphohistiocytosis (HLH): Elusive Diagnosis of Disseminated Mycobacterium avium Complex Infection

Eloy E. Ordaya; Sulieman Abu Jarir; Robert Yoo; Pranatharthi H. Chandrasekar

doi:10.18683/germs.2017.1120

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Case Report

Published: 1 September 2017

Hemophagocytic Lymphohistiocytosis (HLH): Elusive Diagnosis of Disseminated Mycobacterium avium Complex Infection

and

Division of Infectious Diseases, Henry Ford Hospital, P.O. Box 553920, 2799 W. Grand Blvd, Detroit, MI 48202-3920, USA

Hamad Medical Corporation, Hamad General Hospital, P.O. Box 3050, Al Rayyan Rd, Doha, Qatar

Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA

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Division of Infectious Diseases, Wayne State University School of Medicine/Harper University Hospital, 3990 John R, Detroit, MI 48201, USA

GERMS2017, 7(3), 149-152;https://doi.org/10.18683/germs.2017.1120

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Abstract

Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a clinical syndrome of hyperinflammation leading to an uncontrolled and ineffective immune response, associated with high mortality. Case report: A 26-year-old woman with acute lymphoblastic leukemia, 8 months in remission, was found to have HLH. Without any improvement, stem cell transplantation was considered. Then, Mycobacterium avium complex (MAC) infection was identified as cause of her HLH. With appropriate therapy for infection, HLH improved and transplantation was averted. Conclusion: MAC should be included in the list of potential causes of HLH.

Keywords:

hemophagocytic lymphohistiocytosis; atypical mycobacteria; unexplained fever; pancytopenia

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