EB virus infection-associated hemophagocytic lymphohistiocytosis complicated with giant axillary lymph nodes: A case report.

Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal multisystem inflammatory disorder with nonspecific clinical manifestations. Early diagnosis of this condition is inherently challenging. Here, this study reports a case of hemophagocytic lymphohistiocytosis associated with Epstein-Barr virus (EBV) infection with giant axillary lymph nodes. A 50-year-old woman presented with HLH who presented with fever and shock, followed by rapid impairment of liver and coagulation function, accompanied by giant lymph nodes in the right axilla. Bone marrow examination revealed no abnormality. Epstein-Barr virus load of nucleic acid in peripheral blood was 1.65 × 106 copies/mL. The number of EBV sequences detected by high-throughput sequencing was 543, which confirmed EBV infection. We treat patients with symptomatic and supportive care. The patient responded to symptomatic and supportive treatment and was discharged. At 2-month follow-up, the patient had no complaints, and the EBV load of nucleic acid was <500 copies/mL. In patients presenting with fever and shock followed by rapid impairment of liver function and coagulation function, and enlarged axillary lymph nodes, the possibility of EBV-HLH should be considered. Early identification and initiation of etiologic treatments for EBV-HLH are pivotal for good prognosis of patients.