Acquired hemophagocytic syndrome related to parainfluenza virus infection: case report

INTRODUCTION: We present the case of a patient with acquired hemophagocytic syndrome secondary to parainfluenza virus infection, a complication that has not, to the best of our knowledge, been previously reported. CASE PRESENTATION: A 33-year-old Chilean man with fever secondary to parainfluenza 2 virus infection developed progressive cholestasis, hepatosplenomegaly, cytopenia and an increased ferritin level (>2000IU/L). A bone marrow analysis showed hemophagocytosis. Our patient received HLH-94 chemotherapy, and he achieved complete and sustained remission after a two-year follow-up, without the need for hematopoietic stem cell transplantation. CONCLUSION: Hemophagocytic syndrome is a severe disease with high mortality. A high index of suspicion is essential to improve survival. A viral etiology is frequent and although Epstein-Barr virus is the most frequently associated, other viruses like parainfluenza can cause this disease.