{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:25:24Z","timestamp":1792686324476,"version":"4.5.0"},"reference-count":15,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T00:00:00Z","timestamp":1723852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Hemophagocytic lymphohistiocytosis (HLH) is a serious haematologic condition that can be related to various diseases, including tuberculosis (TB). The patient is a previously healthy 26-year-old man, originally from western Africa, admitted to hospital for fever and weight loss. Given the results of a computed tomography (CT) scan, ocular examination and microbiologic tests, miliary TB with pulmonary, lymph nodal and ocular involvement was diagnosed. Following the introduction of antitubercular treatment (ATT), an increase in inflammation indexes and severe pancytopenia were observed; at this point, the patient presented with six of the eight diagnostic criteria for HLH, and a diagnosis of HLH secondary to TB was raised. Therefore, HLH treatment with a high dose of dexamethasone was started, with a good clinical response. We performed a literature review of TB-related HLH, which shows a high mortality rate. ATT is necessary to ensure patient survival to remove the antigenic driver. Our patient developed HLH after the initiation of ATT as a paradoxical reaction, which may be linked to the release of antigens due to the bactericidal effect of ATT.<\/jats:p>","DOI":"10.3390\/idr16040058","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T10:11:28Z","timestamp":1724062288000},"page":"763-769","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hemophagocytic Lymphohistiocytosis and Miliary Tuberculosis in an Apparently Immunocompetent Patient: A Case Report"],"prefix":"10.3390","volume":"16","author":[{"given":"Filippo","family":"Ducci","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2796-8621","authenticated-orcid":false,"given":"Francesca","family":"Mariotti","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Mencarini","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, San Jacopo Hospital, Azienda ASL Toscana Centro, 51100 Pistoia Pe, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra Francesca","family":"Manunta","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, San Jacopo Hospital, Azienda ASL Toscana Centro, 51100 Pistoia Pe, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Messeri","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, San Jacopo Hospital, Azienda ASL Toscana Centro, 51100 Pistoia Pe, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9184-5089","authenticated-orcid":false,"given":"Paola","family":"Parronchi","sequence":"additional","affiliation":[{"name":"Immunology and Cellular Therapies Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Blanc","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, San Jacopo Hospital, Azienda ASL Toscana Centro, 51100 Pistoia Pe, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9758-1523","authenticated-orcid":false,"given":"Alessandro","family":"Bartoloni","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,17]]},"reference":[{"key":"ref_1","first-page":"82","article-title":"Pathophysiology and Epidemiology of Hemophagocytic Lymphohistiocytosis","volume":"177","author":"Allen","year":"2015","journal-title":"Hematol. 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Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1007\/s15010-012-0376-9","article-title":"Paradoxical reactions during treatment of tuberculosis with extrapulmonary manifestations in HIV-negative patients","volume":"41","author":"Geri","year":"2013","journal-title":"Infection"}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/16\/4\/58\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:38:03Z","timestamp":1760110683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/16\/4\/58"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,17]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["idr16040058"],"URL":"https:\/\/doi.org\/10.3390\/idr16040058","relation":{},"ISSN":["2036-7449"],"issn-type":[{"value":"2036-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,17]]}}}