{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:25Z","timestamp":1756339585978,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,8,23]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>Multidrug therapy has significantly reduced the global burden of Hansen\u2019s disease; however, complications from long-term treatment persist. A male resident of southern Kentucky, in his 30s and of Micronesian descent, presented with worsening abdominal pain associated with anorexia, fatigue, functional decline and occasional haemoptysis. He was compliant with multidrug therapy for leprosy. Laboratory investigations revealed pancytopenia. He was initially treated under a sepsis protocol and later switched to high-dose steroids due to a suspected immune reaction from missed corticosteroid doses. Despite aggressive treatment for refractory pancytopenia, the patient\u2019s condition deteriorated, and he passed away from cardiac arrest. Posthumous bone marrow biopsy revealed haemophagocytic lymphohistiocytosis secondary to disseminated histoplasmosis with bone marrow infiltration. This case highlights the importance of proactive fungal screening in immunocompromised leprosy patients, particularly in endemic regions, as early detection and timely intervention can prevent severe complications.<\/jats:p>","DOI":"10.1136\/bcr-2024-262041","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:16:00Z","timestamp":1726100160000},"page":"e262041","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Haemophagocytic lymphohistiocytosis secondary to disseminated histoplasmosis in a patient with leprosy"],"prefix":"10.1136","volume":"17","author":[{"given":"Syed","family":"Mufarrih","sequence":"first","affiliation":[{"name":"Medical Center Health Bowling Green, Bowling Green, Kentucky, USA"},{"name":"Bowling Green Campus, University of Kentucky College of Medicine, Bowling Green, Kentucky, 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