Disseminated histoplasmosis and hemophagocytic lymphohistiocytosis: A case report

Hemophagocytic lymphohistiocytosis (HLH) is an immune deregulatory disorder resulting in severe inflammation and potentially fatal complications involving the bone marrow, liver, or brain; HLH can be considered primary. Secondary HLH is often associated with a specific trigger, including infectious trigger that could be bacterial, viral, fungal or parasitic. Histoplasmosis-associated HLH is a relatively rare but previously reported complication. This case report presents a patient with HLH caused by disseminated histoplasmosis who was treated with etoposide, rituximab, amphotericin B, and itraconazole. This case report aims to highlight the importance of keeping a broad differential for when patients present with fevers of unknown origin.