EBV Meningoencephalitis: Two case reports

Document Type : Case Reports

Authors

1 Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran

2 Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

3 Department of Medicine, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran

4 Clinical Laboratory Department of Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract

 Usual neurological complications of Epstein-Barr virus infection are aseptic meningitis, encephalitis, transverse Usual neurological complications of Epstein-Barr virus infection are aseptic meningitis, encephalitis, transverse myelitis, cerebellitis, Guillain-Barre syndrome, and cranial or peripheral neuritis most commonly in immunocompromised patients. These clinical manifestations may occur alone or accompanied by infectious mononucleosis. Usually, EBV encephalitis occurs infrequently and with non-specific symptoms. Herein, we report two patients: a 24-year-old female with generalized tonic-clonic fever and seizures for ten days. The other was a 28-year-old male with repeated fever, headache, 4-day amnesia, and symptoms of meningeal irritation. Since the physical examination results were not very helpful, the definite diagnosis was achieved by sampling, analysis, and polymerase chain reaction for the cerebrospinal fluid. Our patients had a direct EBV invasion of the CNS and were affected by Epstein-Barr virus encephalitis, confirmed by their clinical test results as a positive polymerase chain reaction of cerebrospinal fluid. The PCR results were negative for a panel of microorganisms that cause bacterial meningitis in the CSF, but positive for EBV. Image findings also did not show any significant results. Patients treated with acyclovir and precision control at the relative center with favorable outcomes. Acyclovir possibly will lessen viral replication. Finally, despite obtaining negative test results of EBV infection, every therapeutic effort should be undertaken and maintained continuous attention. 

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