# An Unusual Presentation of Secondary Hemophagocytic Lymphohistiocytosis With Melena: A Case Report

## TL;DR

This case report describes an adult male with secondary hemophagocytic lymphohistiocytosis triggered by typhoid, highlighting the importance of early diagnosis and corticosteroid treatment for recovery.

## Contribution

The report presents a rare case of secondary HLH with melena, emphasizing diagnostic challenges and successful corticosteroid therapy.

## Key findings

- The patient's clinical course and lab results met established HLH diagnostic criteria.
- High-dose methylprednisolone treatment led to clinical and hematological recovery.
- The case highlights the need to differentiate HLH from sepsis and other similar conditions.

## Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome characterized by excessive immune activation leading to multiorgan involvement. We present a case of an adult male with secondary HLH triggered by typhoid infection, manifesting with persistent fever, cytopenias, hepatosplenomegaly, and bone marrow hemophagocytosis. This report details the clinical presentation, laboratory findings, diagnostic challenges, management, and outcome, underscoring the importance of timely diagnosis and corticosteroid therapy. The clinical course and investigations fulfilled the established diagnostic criteria, illustrating the complexities of differentiating HLH from sepsis and other mimickers. Treatment with high-dose methylprednisolone led to clinical and hematological recovery. This case aligns with literature emphasizing early recognition and immunosuppressive therapy for improved prognosis in secondary HLH.