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Unusual association of diseases/symptoms
CASE REPORT
Hemophagocytic lymphohistiocytosis: a rare association with pulmonary cryptococcosis
  1. Pawan Kumar Singh1,
  2. Rakesh Kodati1,
  3. Manish Rohilla2 and
  4. Prashant Sharma3
  1. 1 Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2 Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  3. 3 Haematology Department, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Rakesh Kodati, kodatirakesh{at}gmail.com

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome characterised by unregulated macrophage and T-lymphocyte activation, resulting in cytokine overproduction and subsequent histiocytic phagocytosis. Here we report a case of pulmonary cryptococcosis, in a 59-year-old diabetic patient, with no other risk factors whose clinical course was complicated by secondary hemophagocytosis. Even after addressing the primary underlying illness (pulmonary cryptococcosis), his clinical condition continued to worsen. After excluding the other causes of HLH and possible reasons of his clinical worsening, glucocorticoids were added following which the patient experienced a remarkable improvement in his clinical and laboratory parameters. To our knowledge, this is the first case report of HLH being caused by pulmonary cryptococcosis and only second case report of cryptococcosis being complicated with HLH (previous report being associated with meningoencephalitic cryptococcosis).

  • cryptococcosis
  • haematology (drugs and medicines)
  • pneumonia (infectious disease)

http://dx.doi.org/10.1136/bcr-2019-230255

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    Footnotes

    • Contributors PKS involved in patient management, concept, planning, initial drafting and correction of the manuscript. RK involved in patient management, concept, initial drafting and final preparation of the manuscript, and is the guarantor of the overall content. MR and PS involved in patient management, concept, planning and review of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.