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CASE REPORT
Year : 2021  |  Volume : 64  |  Issue : 1  |  Page : 192-194

Hemophagocytic lymphohistiocytosis secondary to Candida albicans and reactivated EBV infections: A case report and review of the literature


1 Department of Nursing, The Thrid Affiliated Hospital of Jinzhou Medical University, Liaoning Province, China
2 Department of Clinical Laboratory, Affiliated Hospital of Engineering, University of Hebei, Handan, China
3 Department of Hematology, Affiliated Hospital of Engineering, University of Hebei, Handan, China
4 Department of Medical Imaging, Affiliated Hospital of Engineering, University of Hebei, Handan, China
5 Department of Blood Transfusion, Affiliated Hospital of Engineering, University of Hebei, Handan, China
6 Department of Clinical Laboratory, Chest Hospital of Hebei Province, Hebei Province, China

Correspondence Address:
Xiaolei Chai
Department of Blood Transfusion, Affiliated Hospital of Engineering, University of Hebei, Handan, Hebei Province
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPM.IJPM_457_20

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Hemophagocytic lymphohistiocytosis (HLH) has been recognized as a potentially life-threatening syndrome. This is the first case of acquired HLH caused by dual infections with Candida albicans and reactivated EBV infections, which focuses on the importance of morphological awareness of peripheral blood and bone marrow because sometimes they are the only locations that HLH and fungal microorganisms can be diagnosed. A 29-year-old woman with a history of abdominal distension and 9 months of intermittent fevers ($38.8°C) was admitted to the hematology department with treatment for leukopenia and thrombocytopenia. Severe infection of bilateral pulmonary and marked hepatosplenomegaly were detected by computed tomography. EB virus-CA IgG, EB virus-NA IgG and EB virus-CA IgM were positive. Scattered yeast-like fungi were found on peripheral blood and bone marrow (BM) smears. BM smears indicated prominent hemophagocytosis. Cultures of bronchoalveolar lavage and BM confirmed the growth of C. albicans. A diagnosis of HLH caused by dual infections with Candida albicans and reactivated EBV infections was established based on the clinical features of the patient because 7 of the 8 diagnostic criteria were met. She was treated with etoposide, dexamethasone for HLH, as well as highly active antifungal and antiviral therapies for the underlying etiology of dual infections. The patient eventually recovered following the effective treatment. A timely and accurate diagnosis is crucial to the prognosis of the dangerous disease.


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