Leishmania e linfoistiocitosi emofagocitica (HLH)

Haemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening hyperinflammatory syndrome. The paper reports the case of a 5-month-old infant hospitalised with persistent fever, splenomegaly and significant inflammatory activation. After an initial suspect of genetic HLH that was refractory to immunosuppressive therapy, further evaluation revealed the presence of Leishmania in the bone marrow, confirmed by molecular biology. Treatment with liposomal amphotericin B and immunosuppression tapering led to clinical improvement. This case highlights the importance of thorough differential diagnosis to avoid inappropriate treatments in potentially fatal conditions.