We present a case of immunocompetent boy with brain abscess (BA) complicating hemophagocytic lymphohistiocytosis (HLH) and Kawasaki disease (KD), which is rarely reported. During the recovery period of BA, he had another fever accompanied by enlarged lymph nodes, eye conjunctival congestion, strawberry tongue, swelling on hands and feet, and exanthema. Simultaneously, further investigations revealed bicytopenia, liver dysfunction, hyperferritinemia, coagulopathy and hemophagocytosis. The patient was treated with antibiotics, intravenous immunoglobulin (IVIG) and steroid that led to rapid resolution. Our report highlights the importance of early detection and treatment of HLH, and possible resolution without using immunosuppressive therapy in infectious patients.