Case Report: Hemophagocytic lymphohistiocytosis secondary to Escherichia coli infiltration of bone marrow in a patient with seronegative rheumatoid arthritis treated with low-dose methotrexate - Takeaways - MDSpire

Case Report: Hemophagocytic lymphohistiocytosis secondary to Escherichia coli infiltration of bone marrow in a patient with seronegative rheumatoid arthritis treated with low-dose methotrexate

  • By

  • Ziping Liu

  • Fengjian Li

  • Yunhong Liu

  • Xueyan Chen

  • July 13, 2026

Share

  • 1

    Hemophagocytic lymphohistiocytosis (HLH) is a severe condition characterized by dysregulated immune activation and excessive inflammation.

  • 2

    A case of fatal HLH was reported in a seronegative rheumatoid arthritis patient due to an E. coli urinary tract infection while on low-dose methotrexate.

  • 3

    Bone marrow analysis revealed hemophagocytes and phagocytes containing E. coli, indicating profound immunosuppression and severe bacteremia.

  • 4

    The patient presented with symptoms including abdominal pain, diarrhea, and skin ecchymoses, leading to a diagnosis of sepsis and HLH.

  • 5

    Laboratory findings included severe pancytopenia and elevated inflammatory markers, supporting the diagnosis of HLH secondary to E. coli infection.

Original Source(s)

Case Report: Hemophagocytic lymphohistiocytosis secondary to Escherichia coli infiltration of bone marrow in a patient with seronegative rheumatoid arthritis treated with low-dose methotrexate

  • by Ziping Liu, Fengjian Li, Yunhong Liu, Xueyan Chen

  • July 13, 2026

Related Content

Complement receptor 2 downregulation is associated with mortality in Staphylococcus aureus sepsis in both mice and humans

Determinants of thrombocytopenia in critically ill patients: a systematic review and meta-analysis

Concurrent B-cell acute lymphoblastic leukemia and plasma cell neoplasm with plasmablastic features supporting divergent evolution from a shared precursor: a case report