Hemophagocytic Lymphohistiocytosis as a Presenting Manifestation of Tuberculosis: A Report of Two Cases

We highlight two adult cases of secondary HLH triggered by mycobacterium tuberculosis. The first case, a 68-year-old succumbed to his illness due to lack of a definitive ante mortem diagnosis and rapid disease progression. In contrast, the second patient received a rapid evaluation and prompt diagnosis, with timely initiation of ATT and complete recovery. Both patients had evidence of disseminated tuberculosis with involvement of multiple organs, including the lungs, pleura, spleen, liver, and bone marrow. Prompt recognition and treatment of tuberculosis in patients with HLH are vital to prevent rapid disease progression and reduce mortality that to in developing countries like India where tuberculosis is more prevalent.