{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:19:15Z","timestamp":1783430355373,"version":"3.54.6"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Secondary hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome most commonly triggered by infection, malignancy, or transplant-related immune dysregulation. Rapidly growing mycobacteria are uncommon causes of disseminated infection and have only rarely been reported as infectious triggers of HLH. A 56-year-old immunocompromised woman with a history of allogeneic hematopoietic stem cell transplant presented with recurrent fever, progressive transaminitis, and laboratory features consistent with secondary HLH. Liver biopsy showed granulomatous hepatitis with iron overload. Initial treatment with dexamethasone and anakinra resulted in transient clinical improvement. Less than 2 weeks later, she was readmitted with worsening hepatic dysfunction and found to have acid-fast bacilli in blood and bone marrow cultures, later identified as\n                    <jats:italic toggle=\"yes\">Mycobacterium immunogenum.<\/jats:italic>\n                    Despite targeted antimicrobial therapy, the patient developed progressive hepatic and renal failure and died. To our knowledge, this case represents the first reported case of disseminated\n                    <jats:italic toggle=\"yes\">M. immunogenum<\/jats:italic>\n                    infection precipitating secondary HLH, expanding the recognized clinical spectrum of this rapidly growing nontuberculous mycobacterium and highlights the diagnostic challenges of atypical mycobacterial infection in immunocompromised hosts.\n                  <\/jats:p>","DOI":"10.4103\/ijmy.ijmy_84_26","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:16:59Z","timestamp":1782857819000},"page":"179-182","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Disseminated Mycobacterium immunogenum-associated Hemophagocytic Lymphohistiocytosis after Stem Cell Transplantation"],"prefix":"10.4103","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7558-3718","authenticated-orcid":false,"given":"Robert Sean","family":"Tyler","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew W.","family":"Charles","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra G.","family":"Mills","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosra","family":"Alkabab","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"R1-20260707","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1056\/NEJMra2314005","article-title":"Hemophagocytic Lymphohistiocytosis","volume":"392","author":"Henter","year":"2025","journal-title":"N Engl J Med"},{"key":"R2-20260707","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1038\/s41409-019-0637-7","article-title":"Haemophagocytic lymphohistiocytosis (HLH) following allogeneic haematopoietic stem cell transplantation (HSCT)-time to reappraise with modern diagnostic and treatment strategies?","volume":"55","author":"Sandler","year":"2020","journal-title":"Bone Marrow Transplant"},{"key":"R3-20260707","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1186\/s12879-019-4061-9","article-title":"Nontuberculous mycobacterium infection complicated with 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Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmy.ijmy_84_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:02:30Z","timestamp":1783429350000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmy.ijmy_84_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmy.ijmy_84_26","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-03-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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