Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially a fatal disease. It is either primary or secondary and it is linked to various etiologies. Its therapeutic management is always difficult and not codified in the absence of large-scale controlled studies. We report a case of secondary HLH associated with hematopoietic tuberculosis in an immunocompetent adult. (C) 2015 The Egyptian Society of Chest Diseases and Tuberculosis. Production and hosting by Elsevier B.V.