In this case, we report a patient with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis, mainly manifesting as fever, no liver function damage or HLH related gene mutation. After treated with cortisol and intravenous immunoglobulin, the fever got controlled and most aboratory examinations returned to normal. It suggests that we should attach importance to individualized stratified treatment in clinical practice, avoid overtreatment, and reduce the toxic and side effects of drugs.