The incidence of babesiosis is increasing and clinicians should have a high index of suspicion due to its diagnostic challenges and variable disease course, from asymptomatic infection to fulminant disease. We present a case of fatal secondary hemophagocytic lymphohistiocytosis (sHLH) due to acute babesiosis in a previously healthy adult. We also present a comprehensive review of previously reported sHLH cases triggered by babesiosis. Host factors, such as immunocompromising conditions or medications, appear to be a risk factor for developing sHLH while it is unclear if percent parasitemia of babesia correlates with development or outcomes of HLH. Increasing awareness to improve time to diagnosis is vital for treating both babesiosis and sHLH, while future studies should investigate the role for immunomodulator therapy in this setting.
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http://dx.doi.org/10.1016/j.idcr.2025.e02172 | DOI Listing |
Cureus
February 2025
Internal Medicine, AdventHealth, Orlando, USA.
Establishing the diagnosis of miliary tuberculosis (TB) can be challenging due to the heterogeneous clinical presentations and low sensitivity of diagnostic tests. Miliary TB shares overlapping clinical, radiological, and histopathological features with other chronic granulomatous diseases, such as sarcoidosis, often posing a significant diagnostic challenge for clinicians. A 36-year-old male from Haiti presented with a four-month history of recurrent fever, dry cough, night sweats, and weight loss.
View Article and Find Full Text PDFEur J Case Rep Intern Med
February 2025
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA.
Unlabelled: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome often misdiagnosed due to its rarity and overlapping symptoms with sepsis or organ dysfunction. This case report describes a 52-year-old male who developed dengue-induced HLH after traveling to Barbados, presenting with multi-organ failure and laboratory abnormalities, including hyperferritinaemia and elevated IL-2R. Diagnosed via bone marrow biopsy, he was treated with corticosteroids and the IL-1R antagonist anakinra, leading to recovery.
View Article and Find Full Text PDFCase Rep Perinat Med
January 2024
Department of Obstetrics and Gynecology - Maternal-Fetal Medicine, University of Arizona College of Medicine/Banner University Medical Center, Phoenix, AZ, USA.
Objectives: Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder of hypercytokinemia and immune dysregulation. Most commonly diagnosed in the pediatric population due to genetic predisposition, the condition can manifest in the adult population secondary to an immune dysregulating event, such as infection, malignancy, rheumatologic disorders, immunodeficiency, and checkpoint inhibitors. The presentation and diagnosis during pregnancy are extremely rare and elusive.
View Article and Find Full Text PDFLeuk Lymphoma
March 2025
Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Hemophagocytic lymphohistiocytosis (HLH) is a fatal multi-systemic disorder. Patients with HLH are more prone to bleeding, which implies a poor outcome. The objective was to investigate the efficacy of recombinant activated factor VII (rFVIIa) in major intractable bleeding of HLH.
View Article and Find Full Text PDFEffective post-transplant immunosuppression is essential to induce tolerance to allogeneic tissues and promote long-term graft survival. However, suppression of the immune system significantly increases the risk of opportunistic infections. In addition to the ongoing challenge of balancing graft survival and preventing infections, previous gold-standard calcineurin inhibitor-based immunosuppression also posed an increased risk of nephrotoxicity, cardiac disease, and diabetes.
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