PT  - JOURNAL ARTICLE
AU  - Nasir, Ali Zagham
AU  - Khan, Nasir
TI  - Haemophagocytic lymphohistiocytosis secondary to Epstein-Barr and cytomegalovirus coinfection
AID  - 10.1136/bcr-2023-258219
DP  - 2024 May 01
TA  - BMJ Case Reports
PG  - e258219
VI  - 17
IP  - 5
4099  - http://casereports.bmj.com/content/17/5/e258219.short
4100  - http://casereports.bmj.com/content/17/5/e258219.full
SO  - BMJ Case Reports2024 May 01; 17
AB  - Haemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening disorder caused by uncontrolled activation of the immune system, leading to phagocytosis of blood cells and cytokine storm. HLH can manifest in childhood due to a genetic mutation, but in adults HLH arises secondary to viral infections, autoimmune diseases or neoplastic processes. The most common viral infections associated with HLH are Epstein-Barr virus (EBV) and cytomegalovirus (CMV). EBV and CMV coinfection associated with HLH, however, is exceedingly rare. We present a case of HLH secondary to EBV and CMV coinfection in a young adult who presented with recurrent intermittent high-grade fevers and epistaxis. This case illustrates the importance of considering HLH in patients with idiopathic fevers and to consider all the potential aetiologies for HLH to ensure proper treatment.