Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory response characterized by symptoms of fever, hepatosplenomegaly, and cytopenias. It may be a primary disorder (genetic or familial, mainly observed in children) or secondary to infection, malignancy, or rheumatologic disease (more frequently observed in adults). Most diagnostic and therapeutic guidelines for HLH are focused on pediatric patients, and standard treatment for adult HLH has not yet been developed. Here, we describe the case of an 80-year-old man with fever, hepatosplenomegaly, thrombocytopenia, and anemia who was given the diagnosis of HLH associated with tuberculosis and aspergillosis.