Virus-associated hemophagocytic syndrome caused by influ B and varicella-zoster virus co-infection

Abstract

Background:Varicella (chicken pox), which caused by the varicella-zoster virus(VZV), is usually self-limiting and benign. However, VZV can lead to significant and serious complications, especially in immunocompromised patients or accompanied by other pathogens infection. HPS caused by varicella-zoster and influ B virus co-infection is rare. Case presentation:A 15-years-old boy was admitted to our hospital because of general rash, severe back and low back pain. CT scan revealed pneumonia in left upper lobe. Initial blood tests showed normal blood WBC and PLT, mild liver dysfunction, enhanced D-dimer and myocardial enzyme. However, after 4-days treatment of acyclovir, antibiotics, and analgesic therapy, his pain did not relieved and fever developed. At the same time, hyperferritinemia, abrupt reduction on blood WBC and PLT count were observed. Virus-associated hemophagocytic syndrome (VHAS)was confirmed.Then, intravenous drip dexamethasone(10mg/day) and gamma globulin(10mg/day) were administrated. He recovered completely at last. Conclusions:Disseminated Varicella which was accompanied by influenza B virus and bacteria infection is infrequent. Disseminated varicella may cause significant morbidity and even mortality in immunocompromised patients. Hemophilic syndrome induced by duel-virus and bacteria infection is limited and usually fetal.Anti-bacterial therapy, early identification of haemophilus syndrome and timely administration of glucocorticoids and gamma globulin are the key links of treatments.