Hemophagocytic Lymphohistiocytosis Associated With Polyserositis and Salmonella typhi Infection

Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal disease characterized by excessive immune response activation. Numerous conditions, including infectious etiologies, are implicated in its development. We report the case of 16-year-old girl with HLH associated polyserositis and Salmonella typhi infection. A presented high-grade fever abdominal pain that had been ongoing for 20 days. She treated malaria at local hospital was referred to our due worsening her condition. On examination, she found have an enlarged liver spleen, pale skin, hypotension, bilateral basal crackles on chest examination. Her blood profile revealed pancytopenia, elevated C-reactive protein, deranged coagulation profile. Peripheral smears showed anisocytosis, microcytes, hypochromia RBCs, few platelet clumps. bone marrow biopsy increased megakaryocytes hemophagocytes. Ultrasound computed tomography abdomen pelvis hepatosplenomegaly, pericholecystic edema, mild ascites, long-segment diffuse colonic wall thickening, suggesting pancolitis. Blood culture S. typhi, which rarely HLH. The patient started HLH-2004 protocol improvement fourth day initiating therapy, delayed diagnosis, collapsed sixth admission. life-threatening various underlying causes. diagnosis challenging, early prompt treatment crucial better prognosis. association between infection rare, this highlights importance considering unusual etiologies Clinicians should be vigilant about association, especially endemic regions, ensure treatment.