Chorus: Hemophagocyticlymphohistiocytosis You don’t want to be the one to miss this diagnosis High ferritin that’s not from blood transfusion or cirrhosis It’s hemophagocyticlymphohistiocytosis (2/7)

Your patient that is just too sick and won’t come off the vent The sepsis that’s not improving while on pip, tazo and vanc The fever that you still can’t figure out from where it came You know what you’ll be looking for on labs at 4 am *Chorus* (3/7)

When platelets just keep dropping when the patient is inflamed The ESR decreased but CRP remains the same The LFTs are rising and fibrinogen has tanked You should send a ferritin and you might change the game! *Chorus* (4/7)

Inside the bone marrow you find a hungry macrophage The soluble IL-2 is way too high for patient’s age Triglycerides came for the ride and also start to raise The NK cells went on a strike and won’t stop this parade! *Chorus* (5/7)

And don’t forget to check the belly for a large spleen The CNS can hide inflammation from within The rash can give some clues so don’t forget the skin And when in doubt you can always shout: let’s just send the genes! *Chorus* (6/7)