Background: Melioidosis caused by Burkholderia pseudomallei manifests as a variety of infectious symptoms. However, hemophagocytic lymphohistiocytosis (HLH) secondary to bacteraemic melioidosis is rarely documented in the literature. We report a series of fatal cases of melioidosis combined with HLH in one Chinese family.
Case presentation: Three cases of melioidosis with HLH were reported in a family with three children, two boys aged 4 and 6 years and a 12-year-old girl. The most common clinical presentation was fever. A blood culture confirmed B. pseudomallei, and bone marrow aspiration revealed hemophagocytosis. Despite the administration of antibiotics, glucocorticoids and other treatments, all the patients died, and their deaths were attributed to HLH.
Conclusion: Melioidosis complicating HLH is rare in occurrence, but the mortality rate is high. Clinicians should be aware of the risk of a B. pseudomallei bloodstream infection in children.
Keywords: Burkholderia pseudomallei; family; hemophagocytic lymphohistiocytosis; melioidosis.
© 2025 Wan et al.