Abstract
Hemophagocytic lymphohistiocytosis (HLH) is an uncommon yet life-threatening immune disorder in which dysregulated activity of cytotoxic T cells and macrophages leads to excessive cytokine release, uncontrolled inflammation, and damage to multiple organ systems. Secondary forms of HLH may develop in response to infections, malignancies, or autoimmune conditions. We present the case of an 80-year-old woman with longstanding pancytopenia who developed disseminated histoplasmosis complicated by HLH. This report highlights the diagnostic difficulties of HLH in older patients and stresses the importance of recognizing this syndrome promptly when opportunistic infections are suspected.