title: Primary Epstein-Barr virus infection and probable parvovirus B19 reactivation resulting in fulminant hepatitis and fulfilling five of eight criteria for hemophagocytic lymphohistiocytosis.
abstract: A case of primary Epstein-Barr virus (EBV) infection/parvovirus B19 reactivation fulfilling five of eight criteria for hemophagocytic lymphohistiocytosis (HLH) is presented. Despite two coinciding viral infections, massive splenomegaly, and fulminant hepatitis, the patient had a good clinical outcome, probably due to an early onset form of HLH with normal leukocyte count, normal natural killer (NK) cell function, and a lack of hemophagocytosis.
authors.affiliation: Institute of Medical Microbiology, University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07743 Jena, Germany. Electronic address: matthias.karrasch@med.uni-jena.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Karrasch
authors.affiliation: Department of Internal Medicine IV, University Hospital, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Felber
authors.affiliation: Department of Internal Medicine IV, University Hospital, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Keller
authors.affiliation: Emergency Room, University Hospital, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Kletta
authors.affiliation: Institute of Medical Microbiology, University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07743 Jena, Germany.
authors.forename: Renate
authors.initials: R
authors.lastname: Egerer
authors.affiliation: Institute of Medical Microbiology, University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07743 Jena, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bohnert
authors.affiliation: Institute of Medical Microbiology, University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07743 Jena, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Hermann
authors.affiliation: Institute of Medical Microbiology, University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07743 Jena, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Pfister
authors.affiliation: Institute of Pathology, University Hospital, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Theis
authors.affiliation: Institute of Pathology, University Hospital, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Iver
authors.initials: I
authors.lastname: Petersen
authors.affiliation: Department of Internal Medicine IV, University Hospital, Friedrich-Schiller-University, Jena, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stallmach
authors.affiliation: Institute of Medical Microbiology, University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07743 Jena, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Baier
mesh_terms: D000328:Adult; D060085:Coinfection / Q000175:diagnosis*; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis*; D006505:Hepatitis / Q000821:virology*; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000821:virology; D008297:Male; D010322:Parvoviridae Infections / Q000175:diagnosis*; D016732:Parvovirus B19, Human / Q000302:isolation & purification
keywords: Epstein–Barr virus; Hemophagocytic lymphohistiocytosis; Parvovirus B19