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Summary
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.
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Footnotes
Contributors CH is responsible for acquisition of patient data, study of literature, virological diagnosis, analysis and interpretation of findings and creating the manuscript. SB is responsible for access to medical history, critical discussion and revision. JT is responsible for access to medical history, critical discussion and revision. HPD is responsible for pathological examination of the liver, photographic documentation (Figure 1A–D), discussion of the case and critical review of the manuscript.
Competing interests None declared.
Patient consent Not obtained.
Provenance and peer review Not commissioned; externally peer reviewed.