Fatal Case of Haemophagocytic Syndrome Associated With Infection of Plasmodium Falciparum

Haemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory condition which can occur as a primary syndrome (genetic in origin) or arise secondary to infectious, rheumatologic, malignant or metabolic disorders. HLH is characterised by hypercytokinemia and organ infiltration by phagocytozing histiocytes leading to tissue damage. This entity is often under-diagnosed, especially in adults, and specific therapy is not considered early in the disease course. We report a rare and unusual case of haemophagocytic lymphohistiocytosis (HLH) associated with infection by Plasmodium falciparum. The bone marrow aspiration and biopsy showed proliferation of histiocytes with engulfed haematopoietic cells, however patient succumbed to death before treatment for HLH could be started. Thus, this case report emphasizes the need for consideration of diagnosis of HLH in adult patients so as to provide timely diagnosis and prompt treatment to improve the clinical outcome.