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Year : 2020  |  Volume : 13  |  Issue : 10  |  Page : 467-471

Haemophagocytic lymphohistiocytosis secondary to Plasmodium falciparum malaria: Case report and review of the literature

1 Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
2 Hematology Laboratory, Hedi Chaker University Hospital, University of Sfax, Tunisia

Correspondence Address:
Makram Koubaa
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1995-7645.291041

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Rationale: Haemophagocytic lymphohistiocytosis is a rare complication of malaria, which is often misdiagnosed. Patient concerns: A 30-year-old male was admitted to our department for persistent fever, which began after returning from a stay in Guinea-Conakry. The laboratory investigations revealed a pancytopenia and an elevated C-reactive protein. Peripheral smear examination showed Plasmodium falciparum, therefore confirming the diagnosis of malaria. The laboratory tests showed a worsening pancytopenia. Bone marrow aspiration and biopsy revealed images of hemophagocytosis. Diagnosis: The diagnosis of haemophagocytic lymphohistiocytosis complicating malaria infection was established. Interventions: The patient was treated with artemether-lumefantrine. No immunosuppressant treatment was delivered to the patient. He received antipyretic and antimalarial treatment only. Outcomes and lessons: We report a case of haemophagocytic lymphohistiocytosis trigged by malaria infection and we review all reported cases secondary to Plasmodium falciparum malaria by searching PubMed publications till October 2019. Haemophagocytic lymphohistiocytos secondary to malaria should be suspected even in non-severe cases of malaria.

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