A 25‐year‐old male patient reported four weeks of chills, night sweats, weight loss and dyspnoea following one week in Bali, Indonesia, seven weeks prior. His past medical history included Crohn's disease managed for ten years with infliximab, a monoclonal antibody against tumour necrosis factor‐α (TNF‐α). In vitro interferon‐γ release assay (IGRA) performed at age 14 years, which was conducted years after he had travelled to Egypt for two months in childhood, was negative.
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- 1. Henter JI, Samuelsson‐Horne A, Aricò M, et al. Treatment of hemophagocytic lymphohistiocytosis with HLH‐94 immunochemotherapy and bone marrow transplantation. Blood 2002; 100: 2367‐2373.
- 2. La Rosée P, Horne A, Hines M, et al. Recommendations for the management of hemophagocytic lymphohistiocytosis in adults. Blood 2019; 133: 2465‐2477.
- 3. Brastianos PK, Swanson JW, Torbenson M, et al. Tuberculosis‐associated haemophagocytic syndrome. Lancet Infect Dis 2006; 6: 447‐454.
- 4. Solovic I, Sester M, Gomez‐Reino JJ, et al. The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement. Eur Respir J 2010; 36: 1185‐1206.
- 5. Denholm JT, Thevarajan I. Tuberculosis and the traveller: evaluating and reducing risk through travel consultation. J Travel Med 2016; 23: taw008.
- 6. Fehily SR, Al‐Ani AH, Abdelmalak J, et al. Review article: latent tuberculosis in patients with inflammatory bowel diseases receiving immunosuppression — risks, screening, diagnosis and management. Aliment Pharmacol Ther 2022; 56: 6‐27.
- 7. Katrak SS, Li R, Reynolds S, et al. Association of tumor necrosis factor α inhibitor use with diagnostic features and mortality of tuberculosis in the United States, 2010–2017. Open Forum Infect Dis 2022; 9: ofab641.
Patient consent: The patient gave written consent for publication.
We thank Dr Ellen Maxwell, from Melbourne Pathology, for providing the pathology figure.
No relevant disclosures.