A rare case of streptococcal pharyngitis in an adult male causing hemophagocytic lymphohistiocytosis

Hyperinflammatory responses due to cytokine storms involve multiple systems in hemophagocytic lymphohistiocytosis (HLH) leading to morbidities. Multiple bacterial etiologies have been suggested as a cause of secondary HLH but streptococcal infection has only been reported in pediatric cases. Streptococcus has been considered a notorious pathogen due to its ability to interfere with host immunity through the phenomenon of molecular mimicry. This case report shows the sequence of events post-streptococcal pharyngitis in a 28-year-old male, which lead to HLH and fatality to life, and how a timely intervention of steroids salvaged the patient.