Haemophagocytosis

36 yr old male presented with fever 2 days & Drop in Hb to 6.0 gm/dl with thrombocytopenia & Leucopenia. Leucopenia progressed from 3.2 to 0.9 x 10e9/L. He had clinically periungual pigmentation suggesting possibility of an underlying megaloblastic anaemia. His BMA revealed Hemophagocytosis. Gross Giant MC & Giant Metamyelocytes hypersegmented polys were seen. Occ erythroid cells showed megaloblastic features. Dengue test was -ve & MP was not detected.
Final Diagnosis: Infection associated Hemophagocytosis on backdrop of an underlying Megaloblastic Anaemia.