Macrophagic Activation Syndrome Revealing Tuberculosis: A Case Report

We present a case involving an immunocompetent infant diagnosed with miliary tuberculosis complicated by macrophage activation syndrome. Macrophage activation syndrome (MAS), also known as bone marrow hemophagocytosis, presents as a non-specific clinical condition characterized by fever and hepatosplenomegaly. A 22-month-old infant from a non- consanguineous marriage, the only child in the family, was admitted to a regional hospital due to prolonged fever lasting 15 days. The syndrome can manifest as a primary disorder (familial HLH) due to various genetic mutations or as a sporadic secondary disorder triggered by infections, autoimmune diseases, or malignant conditions. The early initiation of antibacillary treatment in AMS complicating tuberculosis without the use of immunosuppressive drugs provides better management and improves the vital prognosis.