{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:04:51Z","timestamp":1756339491120,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,6,4]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Diagnosing secondary haemophagocytic lymphohistiocytosis (sHLH) requires a systematic approach to avoid the potentially fatal consequences. A young man in his 30s, residing in the northwestern part of India, presented to us with fever, poor appetite and weight loss for over 3\u2009months. Primary evaluation at a regional hospital showed that the patient was having hepatosplenomegaly and pancytopenia. The treating team considered a diagnosis of primary HLH and treated him with an etoposide-based regimen. Because of the rapid clinical deterioration and non-responsiveness to therapy, he was referred to our centre. We pursued the possibility of sHLH and repeated a bone marrow examination, which showed <jats:italic>Leishmania donovani<\/jats:italic> bodies with haemophagocytosis. Thereafter, the patient was prescribed liposomal amphotericin B, but unfortunately, he succumbed to the illness. This case reiterates that infection is a frequent trigger of sHLH. The diagnosis of primary HLH in adults should be considered only after excluding all putative infectious causes, particularly in tropical regions.<\/jats:p>","DOI":"10.1136\/bcr-2025-266300","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T10:25:21Z","timestamp":1751279121000},"page":"e266300","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Visceral leishmaniasis concealed under a diagnosis of haemophagocytic lymphohistiocytosis"],"prefix":"10.1136","volume":"18","author":[{"given":"Aman","family":"Bansal","sequence":"first","affiliation":[{"name":"General Medicine, Government Medical College and Hospital, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akshita","family":"Gupta","sequence":"additional","affiliation":[{"name":"General Medicine, Government Medical College and Hospital, Chandigarh, 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and atypical\/unusual hematological findings on bone marrow examination in cases of visceral leishmaniasis","volume":"3","author":"Bhatia","year":"2011","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"2025082708222085000_18.6.e266300.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2008.02.013"},{"key":"2025082708222085000_18.6.e266300.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0903627"},{"key":"2025082708222085000_18.6.e266300.16","unstructured":"National Center for Vector Borne Disease Control, Ministry of Health and Family Welfare, Government of India . 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