An Adult Case of Fulminant Epstein-Barr Virus Infection with Acute Tubulointerstitial Nephritis

An Atypical Presentation of Epstein-Barr Virus Associated Infectious Mononucleosis Mistaken for Pyelonephritis

“…IM, most commonly occurring from EBV, is usually a self-limiting illness that presents with the recognized constellation of findings: fever, pharyngitis, and adenopathy [1,14]. Complications involving almost any organ system may occur and, as in our case, confound the diagnosis [1,3,12,16,17]. Our patient sought medical care early in her course when IM was considered.…”

“…Abdominal pain in EBV-associated IM is especially worrisome in that it may herald splenic rupture, a rare but lifethreatening complication of IM [1,2]. Other serious complications include airway obstruction, liver failure, and renal failure, as well as the even rarer immunologic and central nervous system involvement [1,2,16,17].…”

“…Kidney involvement in IM occurs infrequently. Acute renal failure is extremely rare, but when it occurs it may require renal replacement therapy [16,17]. When acute renal insufficiency occurs, by far the most common finding on renal biopsy is acute interstitial nephritis.…”

“…When acute renal insufficiency occurs, by far the most common finding on renal biopsy is acute interstitial nephritis. A few cases of glomerulonephritis and other diseases of the kidney have also been described in the literature [16]. Urinary abnormalities in the setting of IM were first reported in 1946, where 3% of 556 military recruits diagnosed with IM had microscopic hematuria and proteinuria [18].…”

Viruses and collapsing glomerulopathy: a brief critical review: Table 1.

“…Viral DNA was similarly localized in the case of an HIV-infected individual with interstitial nephritis [41], but viral DNA was not found in cases of idiopathic acute interstitial nephritis [42, 43]. Kunimoto et al .…”