{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:15:55Z","timestamp":1783664155056,"version":"3.55.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    Reactivation of Epstein-Barr virus (EBV) can lead to life-threatening complications beyond hemophagocytic lymphohistiocytosis (HLH). We report a case of severe EBV reactivation in a 24-year-old female. She had persistent high fever, severe leukopenia, hyperinflammatory shock, and myocardial injury, but lacked typical HLH features. Laboratory tests showed elevated proportions of CD3\n                    <jats:sup>+<\/jats:sup>\n                    CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cells and increased interferon-\u03b3 (IFN-\u03b3), interleukin-6 (IL-6), interleukin-10 (IL-10), and high-sensitivity troponin. Interleukin-2 (IL-2) and tumor necrosis factor-\u03b1 (TNF-\u03b1) levels were normal. The inflammatory pathway may be involved as follows: EBV infects B cells and activates specific CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cells. These T cells mainly secrete IFN-\u03b3 without concurrent IL-2 or TNF-\u03b1 release, resulting in moderate macrophage activation and IL-6\/IL-10-related inflammation. This mechanism differs fundamentally from the uncontrolled inflammation in HLH. With glucocorticoids and ganciclovir treatment, the patient\u2019s symptoms and laboratory markers rapidly and completely resolved. This case highlights the heterogeneity of EBV inflammatory response: clinicians should recognize its atypical manifestations, differentiate it from HLH, and provide individualized treatment based on immunophenotypic profiles.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1833536","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:38:29Z","timestamp":1783661909000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epstein-Barr virus reactivation triggers selective IL-6\/IL-10 axis inflammation and CD3+CD8+ T-cell activation leading to severe leukopenia, hyperinflammatory shock, and myocardial injury: a case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Yong","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Classical Chinese Medicine, Chongqing Hospital of Traditional Chinese Medicine","place":["Chongqing, 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