Abstract
Untreated hemophagocytic lymphohistiocytosis (HLH) can be fatal and requires a high degree of clinical suspicion in the setting of an underlying autoimmune disorder, infection, or malignancy. In the presence of multiple infections, it can be challenging to treat the disease, given organ failure and limited options. We present a case of HLH in a patient with chronic lymphocytic leukemia, who was found to have multiple bacterial and fungal infections simultaneously, due in part to construction work on his 200-year-old home.