Epstein-Barr virus pneumonia associated with hemophagocytic syndrome: report of one case

An 8-year-old girl was admitted because of high fever and cough for seven days. The physical examination on admission revealed diffuse moist rales over the left lung field. Her high fever persisted, and she subsequently developed hepatosplenomegaly, lymphadenopathy, skin rashes, subconjunctival hemorrhage, diffuse pulmonary infiltrates, abnormal liver function, anemia, thrombocytopenia, leukocytosis, and hypoalbuminemia. A bone marrow study revealed increased numbers of macrophages with apparent hemophagocytosis. She developed respiratory failure and required artificial ventilation, but finally died despite resuscitative efforts. Serology for EB virus initially revealed negative findings, but on the 24th day after admission, showed IgG antibody to viral capsid antigen 320x (+), and IgM antibody to viral capsid antigen (+). This is a very unusual case of fatal EB virus pneumonia associated with hemophagocytic syndrome.