Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal immunological syndrome characterized by uncontrolled activation of lymphocytes and cytotoxic macrophages, leading to multi-organ dysfunction. We report the case of a young patient with severe acquired HLH who presented with fever, pancytopenia, and acute liver injury associated with central nervous system infection by a bacterial agent rarely associated with this condition (Streptococcus constellatus), alongside a brief review of the current literature. The HLH was secondary to a bacterial infection of the central nervous system, with rapid diagnosis, suspicion, and early immunosuppressive treatment, leading to a favorable outcome. Understanding and recognizing the clinical features of HLH are crucial for early diagnosis, as demonstrated in this atypical case, which highlighted the importance of timely intervention and the role of steroids in managing the disease.