Chennai: A 17-year-old college student has made a successful recovery after enteric fever triggered a rare immune-related complication that progressed to multi-organ failure, requiring intensive care and mechanical ventilation at Apollo Speciality Hospitals, Teynampet.
The teenager was admitted with high-grade fever, vomiting, loose stools, nasal bleeding and breathlessness and was initially diagnosed with enteric fever. Despite treatment, his condition worsened, with a sharp fall in haemoglobin, white blood cells and platelets, along with deteriorating kidney and liver function and markedly elevated ferritin and inflammatory markers.
The persistent fever, falling blood counts and increasing inflammation raised suspicion of secondary Hemophagocytic Lymphohistiocytosis (HLH) — an uncommon condition in which excessive immune activation causes widespread inflammation and can damage multiple organs. A bone marrow examination showed haemophagocytic activity, supporting the diagnosis of enteric fever-associated secondary HLH.
His condition subsequently progressed to Disseminated Intravascular Coagulation (DIC), causing severe clotting abnormalities, followed by kidney and liver dysfunction. He also developed Acute Respiratory Distress Syndrome (ARDS) and required mechanical ventilation.