An Unusual Presentation of Secondary Hemophagocytic Lymphohistiocytosis With Melena: A Case Report

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome characterized by excessive immune activation leading to multiorgan involvement. We present a case of an adult male with secondary HLH triggered by typhoid infection, manifesting with persistent fever, cytopenias, hepatosplenomegaly, and bone marrow hemophagocytosis. This report details the clinical presentation, laboratory findings, diagnostic challenges, management, and outcome, underscoring the importance of timely diagnosis and corticosteroid therapy. The clinical course and investigations fulfilled the established diagnostic criteria, illustrating the complexities of differentiating HLH from sepsis and other mimickers. Treatment with high-dose methylprednisolone led to clinical and hematological recovery. This case aligns with literature emphasizing early recognition and immunosuppressive therapy for improved prognosis in secondary HLH.