BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening 
condition that has a poor prognosis due to the ensuing cytokine storm leading to 
severe organ damage. Current treatment guidelines suggest using a combination of 
steroid- and etoposide-based chemotherapy. CASE REPORT The authors present a 
case of a 41-year-old African-American female who presented with symptoms of 
foodborne illness and who developed multi-organ dysfunction. HLH was suspected 
because of poor response to broad-spectrum antibiotics with a constellation of 
findings, including cytopenia, hypofibrinogenemia, hypertriglyceridemia, and 
hyperferritinemia. Clinical improvement was noted after administration of 
intravenous immunoglobulin and dexamethasone while waiting for the soluble 
interleukin-2 receptor levels; therefore, chemotherapy was not administered.  
CONCLUSIONS Despite the variable and poor prognosis of HLH, early treatment with 
steroids and immunosuppressive therapy is crucial to improving the survival 
rate. The inclusion of immunoglobulin therapy should be considered a treatment 
option for HLH.