ENTERIC FEVER WITH MULTIPLE CO-INFECTIONS AND SUSPECTED HLH FOLLOWING APPENDICITIS: A RARE CLINICAL OVERLAP

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening syndrome defined by excessive immune activation and a hyperinflammatory response. It is classified into primary HLH, associated with genetic mutations, and secondary HLH, which is triggered by infections, malignancies, autoimmune diseases, or other systemic inflammatory conditions. The pathophysiology involves excessive activation of macrophages and cytotoxic T-cells, leading to uncontrolled productionof cytokines and multi-organ dysfunction.