{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:25:22Z","timestamp":1792686322882,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,5,25]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>Haemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening hyperinflammatory syndrome characterised by persistent fevers, cytopenia, hepatosplenomegaly and systemic inflammation. Secondary HLH can be triggered by various aetiologies including infections, malignancies and autoimmune conditions. We highlight the complexity of HLH diagnosis and management by describing a case of an adolescent Salvadoran immigrant with HLH, newly diagnosed HIV, <jats:italic>Streptococcal bacteraemia<\/jats:italic> and disseminated histoplasmosis. The patient presented with neurological and ocular findings along with persistent fevers and cytopenia. He was diagnosed with HLH and treated with anakinra in addition to receiving treatment for HIV, <jats:italic>Streptococcal bacteraemia<\/jats:italic> and histoplasmosis. The patient\u2019s HLH resolved without corticosteroids or chemotherapy, which are considered the mainstays for HLH treatment. This case underscores the need for the evaluation and management of multiple infections and individualised management in patients presenting with HLH to achieve favourable outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2024-260060","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T21:10:24Z","timestamp":1717708224000},"page":"e260060","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Successful management of haemophagocytic lymphohistiocytosis in an adolescent with newly diagnosed HIV\/AIDS and histoplasmosis"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9851-8523","authenticated-orcid":false,"given":"Yagiz Matthew","family":"Akiska","sequence":"first","affiliation":[{"name":"School of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8825-7067","authenticated-orcid":false,"given":"Wei Li Adeline","family":"Koay","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Children's National Hospital, Washington, District of Columbia, USA"},{"name":"Division of Pediatric Infectious Diseases, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1669-6455","authenticated-orcid":false,"given":"Justin","family":"Unternaher","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Children's National Hospital, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-4581","authenticated-orcid":false,"given":"Natella 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