Atypical manifestations of Epstein–Barr virus in children: a diagnostic challenge

Bolis, Vasileios; Karadedos, Christos; Chiotis, Ioannis; Chaliasos, Nikolaos; Tsabouri, Sophia

doi:10.1016/j.jped.2015.06.007

Cited by 41 publications

(43 citation statements)

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“…A thorough research of the literature showed that although rare, Epstein-Barr virus (EBV) can also be linked to FNP [3,4] . Here we present the case of two brothers with an EBV-derived unilateral FNP.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment for Epstein-Barr Virus Otomastoiditis Complicated by Facial Nerve Paralysis: A Case Report of Two Young Brothers and Review of Literature

Eeten

Faber²,

Kunst³

2017

Int Adv Otol

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Section: Introductionmentioning

confidence: 99%

Surgical Treatment for Epstein-Barr Virus Otomastoiditis Complicated by Facial Nerve Paralysis: A Case Report of Two Young Brothers and Review of Literature

Eeten

Faber²,

Kunst³

2017

Int Adv Otol

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“…Dermatitis can be macular, erythematous, petechial, scarlatiniform, urticarial, herpertiform or similar to erythema multiforme, mainly involving the upper limbs and the trunk, and is observed in 5% of patients (9,10). The symptoms are well tolerated and have a low frequency of complications.…”

Section: Discussionmentioning

confidence: 99%

Splenic rupture associated with thrombocytopenic purpura caused by infectious mononucleosis. Case report

González¹,

Torres²,

Martínez³

et al. 2017

Case reports

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Splenic rupture aSSociated with thrombocytopenic purpura cauSed by infectiouS mononucleoSiS. caSe report palabras clave: Infección; Virus de Epstein-Barr; Púrpura; Rotura de bazo.Keywords: Infection; Epstein-Barr virus; Purpura; Spleen Rupture. Case presentation. Female 12-year-old patient presenting with diffuse abdominal pain, distension, nausea, tegument pallor and unquantified fever for two days. Upon admission to the emergency department, hemodynamic decompensation, purpuric lesions and ecchymosis in the limbs were observed. Laboratory and cabinet studies were carried out to confirm anemia, thrombocytopenia and splenic hematoma. Finally, an exploratory laparotomy was performed considering the possibility of hemoperitoneum.Results. The patient presented with splenomegaly, broken subcapsular hematoma, bleeding of 4000mL and accessory spleen lobe with splenic rupture. Conclusions.Spontaneous splenic rupture is a rare but possible complication of infectious diseases. However, its association with thrombocytopenic purpura is extremely rare. RESUMENIntroducción. La rotura esplénica asociada a la presencia de purpura trombocitopénica causada por mononucleosis infecciosa es extremadamente rara; la evolución de los pacientes con mononucleosis infecciosa asociada al virus de Epstein-Barr es benigna y autolimitada y no requiere intervenciones terapéuticas específicas. El cuadro es bien tolerado y tiene una baja frecuencia de complicaciones.Presentación del caso. Paciente femenino de 12 años de edad con dos días de evolución de dolor abdominal difuso, distensión, náuseas, palidez de tegumentos y fiebre no cuantificada, quien a su ingreso al servicio de urgencias muestra datos de descompensación hemodinámica, lesiones purpúricas y manchas equimoticas en extremidades. Se realizan estudios de laboratorio y gabinete que confirman anemia, trombocitopenia y hematoma esplénico, por lo que se practica laparotomía exploradora ante la posibilidad de hemoperitoneo.Resultados. La paciente presenta esplenomegalia, hematoma subcapsular roto con sangrado de 4000mL y lóbulo accesorio de bazo con rotura esplénica.Conclusiones. La rotura espontánea del bazo es una complicación infrecuente pero posible en enfermedades infecciosas; sin embargo, su asociación a purpura trombocitopenica es extremadamente rara.

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“…Primary infection with EBV is more frequent during childhood and causes a mild disease. The disease is typically asymptomatic in 20%-80% of individuals by the age of two-to-three years [1,3]. When uninfected teenagers and young adults are exposed to EBV, approximately 30%-70% will develop infectious mononucleosis (IM) [3].…”

Section: Introductionmentioning

confidence: 99%

“…Following EBV's infection of B cells, a specific set of latency-related genes and transcripts are expressed, and the virus could remain dormant in resting memory B cells, from which it intermittently reactivates at any mucosal site where B cells are present (Table 1) [4,5]. The reactivation of EBV poses a great and difficult challenge to infected hosts [3]. In healthy adults, it is estimated that for every million B cells in circulation, approximately 1 to 50 are infected with EBV, with the number of latently-infected cells in each individual remaining stable for several years [6].…”

mentioning

confidence: 99%

Recent Advances in Diagnostic Approaches for Epstein–Barr Virus

et al. 2020

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my (M.A.H.A.); irekeola@student.usm.my (A.A.I.); hanimkk@usm.my (R.H.S.)Abstract: Epstein-Barr virus (EBV) is the causative agent of many diseases including infectious mononucleosis (IM), and it is associated with different subtypes of lymphoma, sarcoma and carcinoma such as Hodgkin's lymphoma, non-Hodgkin's lymphoma, nasopharyngeal carcinoma, and gastric carcinoma. With the advent of improved laboratory tests for EBV, a timelier and accurate diagnosis could be made to aid better prognosis and effective treatment. For histopathological lesions, the in situ hybridization (ISH) of EBV-encoded RNA (EBER) in biopsy tissues remains the gold standard for detecting EBV. Methods such as the heterophile antibody test, immunofluorescence assays, enzyme immunoassays, Western blot, and polymerase chain reaction (PCR) are also employed in the detection of EBV in different types of samples. The determination of EBV viral load using PCR, however, is gaining more prominence in the diagnosis of EBV-associated diseases. Given the challenge of false positive/negative results that are sometimes experienced during the detection of EBV, variability in results from different laboratories, and the impact of factors such as sample type and the immunological status of patients from whom samples are collected, the need to critically examine these present methods is invaluable. This review thus presents current advances in the detection of EBV, detailing the advantages and disadvantages of the various techniques. In addition, fundamental virological concepts are highlighted to enhance the greater understanding, the proper application, and the interpretation of EBV tests.Pathogens 2020, 9, 226 2 of 17 EBV can infect a wide range of cells and tissues including T and B lymphocytes, nasopharynx and oropharynx squamous epithelial cells, salivary and stomach glands, thyroid glandular epithelial cells, smooth muscle, and follicular dendritic cells [4]. However, EBV primarily infects and replicates in the stratified squamous epithelium of the oropharynx, followed by a latent infection of B lymphocytes [4]. It has been suggested that the EBV infection of B lymphocytes occurs in the oropharyngeal lymphoid organs [2]. In normal carriers, the virus persists in circulating memory B cells and initiates the production of immunoglobulins [1,2]. Following EBV's infection of B cells, a specific set of latency-related genes and transcripts are expressed, and the virus could remain dormant in resting memory B cells, from which it intermittently reactivates at any mucosal site where B cells are present (Table 1) [4,5]. The reactivation of EBV poses a great and difficult challenge to infected hosts [3]. In healthy adults, it is estimated that for every million B cells in circulation, approximately 1 to 50 are infected with EBV, with the number of latently-infected cells in each individual remaining stable for several years [6]. Therefore, EBV coexists with most human hosts without obvious outcomes. However, in some people, the virus is associated with the develo...

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Atypical manifestations of Epstein–Barr virus in children: a diagnostic challenge

Abstract: Physicians should be cautious about uncommon presentations of the viral infection and consider EBV as a causative agent when they encounter similar clinical pictures.

Cited by 41 publications

References 41 publications

Surgical Treatment for Epstein-Barr Virus Otomastoiditis Complicated by Facial Nerve Paralysis: A Case Report of Two Young Brothers and Review of Literature

Surgical Treatment for Epstein-Barr Virus Otomastoiditis Complicated by Facial Nerve Paralysis: A Case Report of Two Young Brothers and Review of Literature

Splenic rupture associated with thrombocytopenic purpura caused by infectious mononucleosis. Case report

Recent Advances in Diagnostic Approaches for Epstein–Barr Virus

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