Hemophagocytic Lymphohistiocytosis Caused by Pyogenic Liver Abscess during Pregnancy: A Case Report and Literature Review

Introduction: Hemophagocytic lymphohistiocytosis during pregnancy is a rare and severe condition, and timely diagnosis is quite difficult. We present the first case of hemophagocytic lymphohistiocytosis caused by pyogenic liver abscess during pregnancy and discuss the clinical presentation. Case Presentation: A 26-year-old Japanese primigravida at 23 weeks of gestation complained of extremely high fever with a fast heart rate (140 beats per minute). She presented with systemic inflammatory response syndrome (SIRS). Only 2 days later, she died. Autopsy findings proved that this was the first case of hemophagocytic lymphohistiocytosis caused by pyogenic liver abscess during pregnancy. Conclusion: Hemophagocytic lymphohistiocytosis should be considered when patients meet the SIRS criteria, especially whose clinical presentation includes extremely high fever (39°C) and a fast heart rate (greater than 110 bpm) during pregnancy, despite relatively normal laboratory data, because such vital signs may be associated with the onset of hemophagocytic lymphohistiocytosis.