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Haemophagocytic lymphohistiocytosis (HLH) is one of the rare haematological syndromes more commonly reported in infants/children than adults. This disease is known for its aggressive dysregulated immune response affecting the host rapidly, causing multiorgan dysfunction and thus carries a high mortality. The disease still remains cryptic in this current decade despite all the developments in the ever-evolving field of haematology. Due to its rare occurrence and being more frequent in infants and the paediatric population, the literature lacks enough data to standardise therapies. Such events in adults and the elderly are invariably related to an underlying insult such as infections, other autoimmune or rheumatological diseases or drugs. We describe an interesting case of a middle-aged Caucasian woman who presented with fever, pancytopenia and hepatitis, who was eventually diagnosed with HLH just in time to receive the life-saving specific treatment as per available guidelines.

Although tuberculosis (TB) is a well-known infection worldwide, the disease involvement in blood vessels, mainly aorta, is quite rare. The objective of this case report is to address the importance of a multidisciplinary approach aiming at successful treatment of tuberculosis, especially when presenting with mycotic aneurysm. We report a case of a 45-year-old woman with the history of sputum positive pulmonary TB, presenting with seizures and eventually found to have developed disseminated infection involving multiple organs, including the aorta. The patient was started on WHO-recommended anti-tubercular treatment but ended up requiring surgical intervention for the aneurysm. Although the main modality of treatment is the use of proper and adequate medical therapy, vascular dissemination in the form of mycotic aneurysm is difficult to be dealt singlehandedly due to their irreversible and multifactorial nature, with infection being the leading cause and their tendency to progress despite the primary infection being treated.