Adult hemophagocytic lymphohistiocytosis triggered by disseminated tuberculosis and Klebsiella pneumoniae co-infection in an immunocompetent individual-a diagnostic challenge

Here in we report a diagnostically challenging case of adult hemophagocytic lymphohistiocytosis (HLH) triggered by disseminated tuberculosis and Klebsiella pneumoniae co-infection an immunocompetent Individual. She was young female presented with complaints fever, abdominal pain jaundice. Her evaluation showed cytopenias, hyperbilirubinemia, transaminitis, hepatosplenomegaly. progressed to have multi-organ involvement the form myocarditis, pleural effusion. Provisional diagnosis fever unknown origin sepsis multiple-organ dysfunction made evaluated for same. Rapid clinical deterioration being normal prompted considering HLH differential diagnoses, bone marrow other criteria been met resulting confirmation Without prior past or family history HLH, secondary suspected substantial possible triggers made, concomitantly immune suppression started corticosteroids. Disseminated diagnosed isolated from bronchioalveolar lavage cultures. As there no significant response culmination, intravenous immunoglobulins were added along treatment triggers-tuberculosis simultaneously. Patient improvement this approach. In conclusion management is different conventional each cause also varies. Furthermore, stresses on importance initiating rapidly tailored approach therapy case.