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

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 <i>Staphylococcus aureus</i> 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.