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Review
. 2025 Feb 18;11(2):158.
doi: 10.3390/jof11020158.

Fungal-Induced Hemophagocytic Lymphohistiocytosis: A Literature Review in Non-HIV Populations

Chia-Yu Chiu  1 , Rachel S Hicklen  2 , Dimitrios P Kontoyiannis  3
Affiliations
Review

Fungal-Induced Hemophagocytic Lymphohistiocytosis: A Literature Review in Non-HIV Populations

Chia-Yu Chiu et al. J Fungi (Basel). .

Abstract

We performed a thorough search of the literature published through December 2024 with no date exclusions on invasive fungal infection (IFI)-induced hemophagocytic lymphohistiocytosis (HLH) in non-human immunodeficiency virus (HIV) patients. The frequency of IFI-induced HLH reported across 16 articles was 9%. Of the 116 identified cases with available clinical information, 53% occurred in immunocompromised patients. IFIs were usually disseminated (76%), with Histoplasma capsulatum being the most common pathogen (51%). IFI and HLH were diagnosed simultaneously in most cases (78%). The 30-day survival rate was 64%. Reported cases had significant heterogeneity in patient characteristics, management strategies, and outcomes.

Keywords: hematologic malignancies; hemophagocytic lymphohistiocytosis; immunocompromised hosts; invasive fungal infection; solid organ transplant.

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Conflict of interest statement

D.P.K. reports honoraria and research support from Gilead Sciences and Astellas Pharma. He received consultant fees from Astellas Pharma, Merck, and Gilead Sciences and is a member of the Data Review Committee of Cidara Therapeutics, AbbVie, Scynexis, and the Mycoses Study Group.

Figures

Figure 1
Figure 1
Flow diagram of the literature review methodology used to identify all reported cases of fungal-induced HLH in non-HIV patients, with no date restriction applied until December 2024. Abbreviations: HIV, human immunodeficiency virus; HLH, hemophagocytic lymphohistiocytosis.
See this image and copyright information in PMC

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