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Background <p>Acquired/secondary Hemophagocytic Lymphohistiocytosis (HLH) is a rare complication following enteric fever.</p> Case presentation <p>A 55-year-old lady from Bangladesh presented with deteriorating clinical symptoms (high-grade fever, diarrhoea, and abdominal pain) for about two weeks and was diagnosed with enteric fever by an immunochromatographic test for Salmonella. With a broad-spectrum antibiotic, her clinical condition did not improve with persistence of fever, diarrhoea, altered consciousness level, and ascites. Based on the clinical symptoms, the laboratory investigations, and an H-score of 208, a high probability of enteric fever-induced secondary HLH was suggested. Based on the revised HLH-2024 diagnostic criteria, the patient was diagnosed as a case of secondary HLH, and injectable Dexamethasone was commenced. Following the administration of Corticosteroids, the patient’s condition gradually improved.</p> Conclusion <p>In patients diagnosed with enteric fever, deteriorating clinical conditions despite getting antibiotics, physicians should consider secondary HLH as a differential diagnosis. Otherwise, diagnosis and management will be delayed, which can lead to morbidity and mortality.</p>

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A Case of Hemophagocytic Lymphohistiocytosis: An Unwonted Complication of Enteric Fever

  • 期刊论文

  • 发表日期：

    2026年4月13日

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  • Rokan Uddin Ahmad,
  • Sudipta Das,
  • Ishtiakul Islam Khan,
  • Al-Amin Islam,
  • S. N. Sarkar,
  • M. A. Hassan Chowdhury

摘要

Background

Acquired/secondary Hemophagocytic Lymphohistiocytosis (HLH) is a rare complication following enteric fever.

Case presentation

A 55-year-old lady from Bangladesh presented with deteriorating clinical symptoms (high-grade fever, diarrhoea, and abdominal pain) for about two weeks and was diagnosed with enteric fever by an immunochromatographic test for Salmonella. With a broad-spectrum antibiotic, her clinical condition did not improve with persistence of fever, diarrhoea, altered consciousness level, and ascites. Based on the clinical symptoms, the laboratory investigations, and an H-score of 208, a high probability of enteric fever-induced secondary HLH was suggested. Based on the revised HLH-2024 diagnostic criteria, the patient was diagnosed as a case of secondary HLH, and injectable Dexamethasone was commenced. Following the administration of Corticosteroids, the patient’s condition gradually improved.

Conclusion

In patients diagnosed with enteric fever, deteriorating clinical conditions despite getting antibiotics, physicians should consider secondary HLH as a differential diagnosis. Otherwise, diagnosis and management will be delayed, which can lead to morbidity and mortality.