Hemophagocytic lymphohistiocytosis secondary to disseminated histoplasmosis in an HIV-negative patient: A case of misdiagnosis

Hemophagocytic lymphohistiocytosis (HLH) secondary to disseminated histoplasmosis (DH) is rare and often misdiagnosed, especially in non-endemic areas. We present a case of a 70-year-old Chinese man who was admitted with fever, nausea, and vomiting, initially misdiagnosed with pulmonary tuberculosis. The use of metagenomic next-generation sequencing (mNGS) played a crucial role in the early and accurate diagnosis, highlighting its potential as a valuable diagnostic tool for rare infections.