{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:20:03Z","timestamp":1776921603837,"version":"3.51.2"},"reference-count":9,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,7,20]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome characterised by unregulated macrophage and T-lymphocyte activation, resulting in cytokine overproduction and subsequent histiocytic phagocytosis. Here we report a case of pulmonary cryptococcosis, in a 59-year-old diabetic patient, with no other risk factors whose clinical course was complicated by secondary hemophagocytosis. Even after addressing the primary underlying illness (pulmonary cryptococcosis), his clinical condition continued to worsen. After excluding the other causes of HLH and possible reasons of his clinical worsening, glucocorticoids were added following which the patient experienced a remarkable improvement in his clinical and laboratory parameters. To our knowledge, this is the first case report of HLH being caused by pulmonary cryptococcosis and only second case report of cryptococcosis being complicated with HLH (previous report being associated with meningoencephalitic cryptococcosis).<\/jats:p>","DOI":"10.1136\/bcr-2019-230255","type":"journal-article","created":{"date-parts":[[2019,8,10]],"date-time":"2019-08-10T13:05:15Z","timestamp":1565442315000},"page":"e230255","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Hemophagocytic lymphohistiocytosis: a rare association with pulmonary cryptococcosis"],"prefix":"10.1136","volume":"12","author":[{"given":"Pawan Kumar","family":"Singh","sequence":"first","affiliation":[{"name":"Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rakesh","family":"Kodati","sequence":"additional","affiliation":[{"name":"Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Rohilla","sequence":"additional","affiliation":[{"name":"Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4741-3403","authenticated-orcid":false,"given":"Prashant","family":"Sharma","sequence":"additional","affiliation":[{"name":"Haematology Department, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,10]]},"reference":[{"key":"2025082622433427000_12.8.e230255.1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2147\/JBM.S46255","article-title":"Hemophagocytic lymphohistiocytosis: review of etiologies and management","volume":"5","author":"George","year":"2014","journal-title":"J Blood Med"},{"key":"2025082622433427000_12.8.e230255.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61048-X"},{"key":"2025082622433427000_12.8.e230255.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(07)70290-6"},{"key":"2025082622433427000_12.8.e230255.4","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/ejh.12886","article-title":"Progressive histoplasmosis with hemophagocytic lymphohistiocytosis and epithelioid cell granulomatosis: a case report and review of the literature","volume":"99","author":"Schulze","year":"2017","journal-title":"Eur J Haematol"},{"key":"2025082622433427000_12.8.e230255.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(98)93594-0"},{"key":"2025082622433427000_12.8.e230255.6","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"2025082622433427000_12.8.e230255.7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-01-551622"},{"key":"2025082622433427000_12.8.e230255.8","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.186627"},{"key":"2025082622433427000_12.8.e230255.9","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1111\/ijlh.12713","article-title":"Diagnostic and prognostic value of low percentage of glycosylated ferritin in acquired hemophagocytic lymphohistiocytosis: a single-center study","volume":"39","author":"Nabergoj","year":"2017","journal-title":"Int J Lab Hematol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230255","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:43:46Z","timestamp":1756273426000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2019,8,10]]},"published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1136\/bcr-2019-230255"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230255","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}