What is your approach to treatment of infection-triggered HLH that does not respond to treatment of the underlying infection?  

The algorithm our center follows is to Recognize hyperinflammation (see answer to question above -- in addition to baseline labs, we obtain an infectious disease consult) Look for and treat the trigger. A concern, if the patient is responding, is that we are missing a trigger (HLH does not occur...

Patients with infection-triggered HLH often require HLH therapy alongside treatment of the underlying infection, especially herpesvirus infections. Patients with infection-related HLH who are extremely ill with organ failure and severe symptoms usually require upfront HLH treatment along with treatm...