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Case Reports in Infectious Diseases
Volume 2016, Article ID 1358742, 5 pages
http://dx.doi.org/10.1155/2016/1358742
Case Report

Histoplasmosis-Induced Hemophagocytic Lymphohistiocytosis in an Adult Patient: A Case Report and Review of the Literature

1Department of Pathology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
2Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA

Received 8 July 2016; Accepted 28 September 2016

Academic Editor: Gernot Walder

Copyright © 2016 Ramona Vesna Untanu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threating immune dysregulation syndrome characterized by persistent activation of the mononuclear phagocytic system leading to uncontrolled systemic hyperinflammatory response. The proliferation and activation of histiocytes and lymphocytes lead to production of large amounts of cytokines, also called cytokine storm. Hematopoietic and lymphoid tissues are directly involved while other organs are damaged by circulating cytokines. Primary HLH is attributed to genetic defects of the immune system and secondary HLH is usually seen in adults secondary to malignancy, infection, or autoimmune diseases. Zoonotic diseases including fungal infections are an important cause of HLH. Secondary HLH can delay the recognition of the underlying zoonoses. We report the case of a 61-year-old female with history of rheumatoid arthritis with histoplasmosis associated hemophagocytic lymphohistiocytosis.