Successful Treatment of Herpes Simplex Virus (HSV)-1-associated Hemophagocytic Lymphohistiocytosis (HLH) with Acyclovir: A Case Report and Literature Review

• Published in: Internal Medicine Vol. 56; no. 21; pp. 2919 - 2923
• Main Authors: Yabushita, Tomohiro, Yoshioka, Satoshi, Koba, Yusuke, Ono, Yuichirou, Hiramoto, Nobuhiro, Tabata, Sumie, Itou, Munehiro, Shimizu, Norio, Tomii, Keisuke, Ishikawa, Takayuki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2017; Japan Science and Technology Agency
• Subjects: Acyclovir; Acyclovir - therapeutic use; Aged; Bone marrow; Case Report; Diagnosis; Fever; hemophagocytic lymphohistiocytosis; Herpes simplex; Herpes Simplex - complications; Herpes Simplex - drug therapy; herpes simplex virus-1; Herpes viruses; Herpesvirus 1, Human; Histiocytosis; Humans; Internal medicine; Literature reviews; Liver; Lymphocytosis; Lymphohistiocytosis, Hemophagocytic - diagnosis; Lymphohistiocytosis, Hemophagocytic - drug therapy; Male; Pancytopenia; Polymerase chain reaction; Viruses; herpes simplex virus-1; hemophagocytic lymphohistiocytosis; acyclovir
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.8490-16

Hemophagocytic lymphohistiocytosis (HLH) associated with herpes simplex virus (HSV)-1 infection (HSV-1-HLH) is uncommon and is potentially fatal without appropriate treatment. We herein report the case of an adult patient with HSV-1-HLH who was successfully treated with acyclovir. A 69-year-old man developed fever, pancytopenia and liver enzyme elevation after the resolution of pneumonia. These findings and the presence of hemophagocytosis in the patient's bone marrow were consistent with a diagnosis of HLH. The patient was diagnosed with HSV-1-HLH based on the results of a polymerase chain reaction (PCR) for HSV-1. The early administration of acyclovir improved his clinical symptoms and laboratory results within two weeks. In the present case, the rapid and precise diagnosis facilitated the successful treatment of HSV-1-HLH.