{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:29:37Z","timestamp":1792794577812,"version":"4.5.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Hemophagocytic lymphohistiocytosis (HLH) secondary to disseminated tuberculosis (TB) is a rare, life-threatening hyperinflammatory syndrome. We present a 60-year-old man with recurrent fever and syncope. Workup revealed cytopenias, hyperferritinemia (peak 5,802 ng\/mL), elevated C-reactive protein (CRP), and hepatic dysfunction, fulfilling HLH-2004 criteria. Imaging showed miliary lung nodules and tuberculous spondylitis at T9. Bone marrow biopsy confirmed hemophagocytosis, and next-generation sequencing identified Mycobacterium tuberculosis. This case demonstrates that disseminated TB can trigger a fulminant cytokine storm even in an elderly host without overt immunodeficiency. Successful outcomes require combined antitubercular and immunomodulatory therapy.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1695605","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:30:26Z","timestamp":1763706626000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Tuberculosis-triggered cytokine storm with hemophagocytic lymphohistiocytosis and tuberculous spondylitis in an apparently immunocompetent host: a case report and literature 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