Mycobacterium chimaera Associated Haemophagocytic Lymphohistiocytosis

Haemophagocytic lymphohistiocytosis (HLH) is a potentially fatal condition in which abnormal activation of the immune system results in haemophagocytosis, inflammation and tissue damage. This results in a variety of signs and symptoms but most commonly fever, lymphadenopathy, splenomegaly, cytopenias, hyperferritinaemia and hypertriglyceridaemia. There are multiple reports of acquired HLH developing on a background of disseminated Mycobacterium infection. Simultaneously, since 2011, cases of invasive cardiovascular infection caused by Mycobacterium chimaera (M. chimaera) in patients having previously undergone cardiac surgery in Europe have been reported. We report a case of acquired HLH occurring one year after open-heart surgery to place a prosthetic valve due to M. chimaera.