{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:27:32Z","timestamp":1792794452595,"version":"4.5.0"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science and Technology Program of Guangdong 2017","award":["2017A020215177"],"award-info":[{"award-number":["2017A020215177"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially life-threatening disorder characterized by an exacerbated but ineffective inflammatory response, which can be classified as primary and secondary HLH. HLH associated with <jats:italic>Mycobacterium tuberculosis<\/jats:italic> is uncommon. This case report accounted an immunocompetent patient who was confirmed to be <jats:italic>Mycobacterium<\/jats:italic> infection, or rather, highly suspected tuberculosis (TB) associated HLH, with a favorable outcome.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 36-year-old man presented with persistent fever, pancytopenia, and hyperferritinemia. A bone marrow smear demonstrated hemophagocytosis, and pathological examination of lung biopsy was positive for acid-fast bacilli, which established the diagnosis of <jats:italic>Mycobacterium<\/jats:italic> infection and HLH. Then the patient treated successfully with anti-TB therapy, along with 8\u2009weeks of etoposide.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This case emphasizes that HLH should be kept in mind when clinicians encounter a patient with severe infection presenting with pancytopenia and hyperferritinemia. Given the high mortality, early diagnosis and appropriate therapy can provide patients with a favorable prognosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-020-05016-4","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T19:03:07Z","timestamp":1588705387000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Successful treatment of mycobacterial infection associated hemophagocytic lymphohistiocytosis with etoposide and anti-tuberculous therapy: a case report"],"prefix":"10.1186","volume":"20","author":[{"given":"Yan-Hong","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Hui","family":"Ba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Wei","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben-Quan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,5]]},"reference":[{"key":"5016_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1146\/annurev-pathol-020117-043625","volume":"13","author":"H Al-Samkari","year":"2018","unstructured":"Al-Samkari H, Berliner N. Hemophagocytic Lymphohistiocytosis. Annu Rev Pathol. 2018;13:27\u201349.","journal-title":"Annu Rev Pathol"},{"issue":"2","key":"5016_CR2","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1002\/pbc.21039","volume":"48","author":"J Henter","year":"2007","unstructured":"Henter J, Horne A, Aric\u00f3 M, et al. HLH-2004: diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer. 2007;48(2):124\u201331.","journal-title":"Pediatr Blood Cancer"},{"key":"5016_CR3","first-page":"220","volume":"47","author":"HS Subhash","year":"2001","unstructured":"Subhash HS, Sowmya S, Sitaram U, Cherian AM. Tuberculosis associated haemophagocytic syndrome. J Postgrad Med. 2001;47:220.","journal-title":"J Postgrad Med"},{"key":"5016_CR4","doi-asserted-by":"publisher","first-page":"2465","DOI":"10.1182\/blood.2018894618","volume":"133","author":"P La Ros\u00e9e","year":"2019","unstructured":"La Ros\u00e9e P, Horne A, Hines M, von BGT MR, Berliner N, Birndt S, Gil-Herrera J, Girschikofsky M, Jordan MB, Kumar A, JAM v L, Lachmann G, Nichols KE, Ramanan AV, Wang Y, Wang Z, Janka G, Henter JI. Recommendations for the management of hemophagocytic lymphohistiocytosis in adults. Blood. 2019;133:2465\u201377.","journal-title":"Blood"},{"key":"5016_CR5","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1007\/s12185-009-0265-x","volume":"89","author":"NW Su","year":"2009","unstructured":"Su NW, Chen CK, Chen GS, Hsieh RK, Chang MC. A case of tuberculosis-induced hemophagocytic lymphohistiocytosis in a patient under hemodialysis. Int J Hematol. 2009;89:298\u2013301.","journal-title":"Int J Hematol"},{"key":"5016_CR6","doi-asserted-by":"publisher","unstructured":"Aggarwal P, Kumar G, Dev N, Kumari P. Haemophagocytic lymphohistiocytosis: a cause for rare but fatal outcome in tuberculosis. BMJ Case Reports. 2012. https:\/\/doi.org\/10.1136\/bcr-2012-006982.","DOI":"10.1136\/bcr-2012-006982"},{"issue":"25","key":"5016_CR7","doi-asserted-by":"publisher","first-page":"2728","DOI":"10.1182\/blood-2017-06-788349","volume":"130","author":"E Bergsten","year":"2017","unstructured":"Bergsten E, Horne A, Arico M, et al. Confirmed efficacy of etoposide and dexamethasone in HLH treatment: long-term results of the cooperative HLH-2004 study. Blood. 2017;130(25):2728\u201338.","journal-title":"Blood."}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-05016-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-020-05016-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-05016-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T23:07:03Z","timestamp":1620169623000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-020-05016-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,5]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["5016"],"URL":"https:\/\/doi.org\/10.1186\/s12879-020-05016-4","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,5]]},"assertion":[{"value":"24 July 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The report was approved by the Ethical and Clinical Research Committee of the Third Affiliated Hospital of Sun Yat-Sen University.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"321"}}