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September 5, 2025

Extended drug-resistant Salmonella Typhi complicated by rare fatal haemophagocytic lymphohistocytosis: A case report

MBMirza Misba Ali BaigIS practice WSWaqas SiddiquiIndus Hospital SSShakeel Ahmed SoomroSindh Agriculture University

Key Points

Haemophagocytic lymphohistiocytosis, a severe inflammatory response, can result from extended drug-resistant infections.
Effective management of extended drug-resistant Salmonella Typhi is crucial as it can lead to complications like HLH.
Infections by Salmonella Typhi are increasingly concerning, particularly in low-income countries with rising resistance rates.
The case emphasizes the importance of early diagnosis and treatment to mitigate the severe outcomes associated with HLH.

Abstract

Haemophagocytic lymphohistiocytosis (HLH) is a deadly hyper-inflammatory clinical response marked by excessive inflammation and tissue damage that can be secondarily triggered by infections, autoimmune and malignancy. HLH is usually caused by viruses and rarely by bacterial infections such as Salmonella enterica serovar Typhi. Its rising incidence of extended drug-resistant (XDR) in low-income countries such as Pakistan can lead to numerous complications but rarely secondary HLH.

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