{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:49:58Z","timestamp":1747190998157,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T00:00:00Z","timestamp":1643241600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Hematology"],"published-print":{"date-parts":[[2022,1,27]]},"abstract":"<jats:p>Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal, and systemic hyperinflammatory syndrome with exacerbated and uncontrolled activation of histiocytes and lymphocytes against mature cells. Secondary HLH can occur in association with a myriad of underlying infections or malignancies. Our patient is a 38-year-old male prisoner with poorly controlled diabetes and no known other medical conditions. He was referred to our emergency department with three-week history of worsening malaise, weight loss, fever, bruising, and shortness of breath; imaging showed pneumomediastinum, lung nodule, and adrenal mass. Biopsy of the lung nodule revealed acid-fast bacilli. Furthermore, bone marrow biopsy showed foci of necrosis with associated acid-fast bacilli and hemophagocytosis highlighted by CD163 stain; consequently, secondary HLH was suggested. Hence, lab results were reviewed and found to satisfy five of the eight secondary HLH criteria. Moreover, ferritin was &gt;10,000\u2009ng\/ml, which has been suggested to be highly suspicious for HLH. The patient was started on anti-MAC therapy. Unfortunately, the patient\u2019s status declined rapidly; he developed multi-organ failure and succumbed to disease. Later, his culture confirmed Mycobacterium tuberculosis. In conclusion, we presented a rare and challenging case of secondary HLH associated with disseminated Mycobacterium tuberculosis. A high index of suspicion is required for early diagnosis and treatment, and pathologists should be aware of Mycobacterium tuberculosis\u2019 association with secondary HLH.<\/jats:p>","DOI":"10.1155\/2022\/4669025","type":"journal-article","created":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T20:05:29Z","timestamp":1643313929000},"page":"1-5","source":"Crossref","is-referenced-by-count":1,"title":["Disseminated Mycobacterium tuberculosis: An Unusual Presentation with Associated Hemophagocytic Lymphohistiocytosis"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-5530","authenticated-orcid":true,"given":"Ahmed","family":"Arfa","sequence":"first","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nivin","family":"Omar","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kulsum","family":"Bano","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1474-9568","authenticated-orcid":true,"given":"Natasha M.","family":"Savage","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-2113.168100"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1177\/2050313X17746309"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-041610-134208"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2005.1.82"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2012-006982"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1007\/bf02724303"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-06-356261"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1002\/art.38690"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1991.tb11878.x"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1993.tb12699.x"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19861215)58:12<2640::aid-cncr2820581216>3.0.co;2-e"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006575"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(06)70524-2"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006575"},{"issue":"23","key":"15","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1182\/blood.2018894618","article-title":"Recommendations for the management of hemophagocytic lymphohistiocytosis in adults","volume":"133","author":"P. La Ros\u00e9e","year":"2019","journal-title":"Blood"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-06-788349"}],"container-title":["Case Reports in Hematology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crihem\/2022\/4669025.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crihem\/2022\/4669025.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crihem\/2022\/4669025.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T20:05:31Z","timestamp":1643313931000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/crihem\/2022\/4669025\/"}},"subtitle":[],"editor":[{"given":"Tomas Jose","family":"Gonzalez-Lopez","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,27]]},"references-count":16,"alternative-id":["4669025","4669025"],"URL":"https:\/\/doi.org\/10.1155\/2022\/4669025","relation":{},"ISSN":["2090-6579","2090-6560"],"issn-type":[{"type":"electronic","value":"2090-6579"},{"type":"print","value":"2090-6560"}],"subject":[],"published":{"date-parts":[[2022,1,27]]}}}