Hemophagocytic syndrome in a patient with disseminated tuberculosis: a case report

Hemophagocytic syndrome (HS) is a rare disorder of the immune system. It is characterized by fever, lymphadenopathy, hepatosplenomegaly, cytopenia and hyperferritinemia. The cause differs in each country suggesting a specific genetic background and epidemiology of infections, and it can be associated with malignant diseases. A rare cause of HS is tuberculosis (TB), we describe a case of HS associated with disseminated Mycobacterium tuberculosis (MT) infection in a patient from Sudan. He presented diarrhea, fever, pancytopenia, thickened and dilated bowel loops and lymph nodes enlargement at ultrasound and computed tomography scan. A bone marrow biopsy performed to rule out a lymphoma revealed a HS. The bronchoalveolar lavage (BAL) culture was then positive for MT and subsequently, radiologic aspects of lung and spleen TB involvement appeared. A disseminated tuberculosis was diagnosed. Despite antituberculous therapy, the patient died as in approximately 50% of the HS associated with TB.