Typhoid Fever Complicating as Secondary Hemophagocytic Lymphohistiocytosis

Hemophagocytic Lymphohistiocytosis (HLH) is an aggressive hematological disorder caused by an uncontrolled activation of Cytotoxic T-Cells (CTL), Natural Killer (NK) cells, and macrophages, leading to hyperinflammation and cytokine storm. It can be classified into either primary or secondary. Triggers like infections, malignancies, and autoimmune conditions can lead to secondary HLH. Viral infections (Epstein–Barr Virus (EBV), Cytomegalovirus (CMV), and parvovirus) are commonly known to cause HLH. Tropical infections like Typhoid are common in India but have infrequently been reported to cause HLH. HLH is a rare complication of typhoid fever. We report a case of an adolescent boy who presented with typhoid fever complicated by secondary HLH.