Brucellosis-associated haemophagocytic lymphohistiocytosis in a child.

Haemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that may be triggered by infections, including brucellosis. Brucellosis-associated HLH is uncommon in children and may mimic malignancy or severe viral illness.We report a school-aged boy who presented with prolonged fever, pancytopenia, hepatosplenomegaly, hyperferritinaemia, hypertriglyceridaemia and hypofibrinogenaemia, fulfilling six HLH-2004 diagnostic criteria. Blood cultures confirmed Brucella species infection.Targeted antimicrobial therapy with gentamicin, doxycycline and rifampicin resulted in complete clinical and haematological recovery without corticosteroids, intravenous immunoglobulin or cytotoxic therapy.This case highlights the importance of recognising infection-triggered HLH in endemic regions and demonstrates that early treatment of the underlying infection may reverse the hyperinflammatory state.