# Sepsis complicated by haemophagocytic lymphohistiocytosis triggered by methicillin-resistant Staphylococcus aureus and human herpesvirus 8 in an immunocompromised elderly patient: A case report

## TL;DR

An elderly immunocompromised patient developed sepsis and HLH due to MRSA and HHV-8, and improved with combined treatment.

## Contribution

This case report highlights the rare co-occurrence of sepsis and HLH triggered by MRSA and HHV-8 in an immunocompromised patient.

## Key findings

- The patient was diagnosed with HLH based on bone marrow findings and elevated soluble CD25 levels.
- Treatment with antibiotics, immunomodulatory agents, and supportive care led to significant improvement.
- Early recognition and a multidisciplinary approach are crucial for managing such complex cases.

## Abstract

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. A rare but severe complication is haemophagocytic lymphohistiocytosis (HLH), an aggressive syndrome of excessive immune activation. Managing both conditions is particularly challenging in patients with multiple comorbidities. A 78-year-old male with a complex history, including myasthenia gravis and chronic kidney disease, was admitted with sepsis. Investigations confirmed infection with methicillin-resistant Staphylococcus aureus and human herpesvirus 8. He was subsequently diagnosed with HLH based on bone marrow findings of haemophagocytosis and elevated soluble CD25 levels. He was treated with a combination of antibiotics, immunomodulatory agents, and supportive care. After 21 days of treatment, the patient’s condition improved significantly. This case highlights the importance of early recognition and timely intervention in the management of sepsis and HLH in patients with multiple comorbidities. A multidisciplinary approach and individualised treatment strategies are crucial for improving patient outcomes.