An elderly patient with varicella-zoster virus-associated hemophagocytic syndrome refractory to steroid therapy

Abstract

We experienced a case of virus-associated hemophagocytic syndrome (VAHS) after varicella-zoster virus (VZV) infection. The patient, a 101-year-old man, presented with anemia, thrombocytopenia and jaundice two weeks after successful anti-viral treatment for the VZV. Histiocytes were detected in the bone marrow examination (2.2%); however, hepatomegaly and triglycemia remained unobserved throughout the course. Reactivation of VZV was detected serologically. The patient died after five weeks because of persistent cytopenia and liver failure refractory to steroid treatment. An autopsy revealed hemophagocytosis in the bone marrow, lung, spleen and liver.