Disseminated tuberculosis complicated by hemophagocytic lymphohistiocytosis in an immunocompetent adult with favorable outcomes: A case report.

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon hyperinflammatory syndrome characterized by excessive activation of macrophages and T-cells with high cytokines levels, causing multiorgan dysfunction.HLH has been associated with variable infectious etiologies, such as tuberculosis(TB). TB-associated HLH (TB-HLH) is a rare condition, but it is fatal if not treated. The diagnosis of TB-HLH is challenging and might be missed if not highly considered. The classic manifestations of HLH include pancytopenia, organomegaly, lymphadenopathy, and coagulopathy. Herein, we present a young immunocompetent adult diagnosed with disseminated TB complicated by HLH. Our patient responded well to the combination of antituberculosis therapy(ATT), corticosteroid, and intravenous immunoglobulin(IVIG). This case highlights the importance of considering this fatal complication in TB patients.

A case of post COVID-19 multisystem inflammatory syndrome and Bell's palsy in a young adult.

The clinician should put MIS-A at the top of differential diagnoses of a patient with febrile illness and multiple organ dysfunction during the early post-COVID-19 period. Also, facial nerve palsy might follow COVID-19, related to the autoimmune phenomenon.