title: Haemophagocytic lymphohistiocytosis associated with fulminant hepatitis and multiorgan failure following primary Epstein-Barr virus and herpes simplex virus type 1 infection.
abstract: We present a case of severe fatal hepatitis in a young patient presumably triggered by two ubiquitous viral diseases which occurred in close succession. This case is unusual because of the exceptional chronological sequence of primary Epstein-Barr virus and herpes simplex virus type 1 infection causing systemic immune dysregulation associated with rapidly developing liver failure and consecutive multiorgan failure. Clinical, laboratory and histopathological findings indicated the development of secondary haemophagocytic lymphohistiocytosis triggered by these closely succeeding viral primary infections.
authors.affiliation: Division of Clinical Virology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Claudia
authors.identifier: http://orcid.org/0000-0002-3051-2686
authors.initials: C
authors.lastname: Honsig
authors.affiliation: Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Sandra
authors.initials: S
authors.lastname: Beinhardt
authors.affiliation: Kepler Universityclinic, Med Campus III, Linz, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Tomasits
authors.affiliation: Medical University of Vienna, Institute of Clinical Pathology, Vienna, Austria.
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Dienes
mesh_terms: D001344:Autopsy; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D017809:Fatal Outcome; D006505:Hepatitis / Q000150:complications / Q000209:etiology; D006561:Herpes Simplex / Q000150:complications*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D006801:Humans; D017114:Liver Failure, Acute / Q000150:complications / Q000209:etiology*; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis*; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology* / Q000821:virology; D055815:Young Adult