Fatal brainstem encephalitis caused by Epstein-Barr virus

Shian, Wen-Jye; S., C.

doi:10.1007/bf02012744

Cited by 24 publications

(6 citation statements)

References 4 publications

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“…Although the prognosis of EBV encephalitis is usually good in the majority of cases (85%), it can be fatal in some patients [ 12 , 13 ]. In our patient, acyclovir therapy was initiated empirically and it was then continued to manage severe neurological symptoms, even after EBV diagnosis was made.…”

Section: Discussionmentioning

confidence: 99%

Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

Akkoç

Kadayıfçı

Karaaslan

et al. 2016

Case Reports in Infectious Diseases

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Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae.

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Section: Discussionmentioning

confidence: 99%

Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

Akkoç

Kadayıfçı

Karaaslan

et al. 2016

Case Reports in Infectious Diseases

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“…18 The infectious agents that may cause rhombencephalitis include bacteria (i.e., Listeria monocytogenes, Mycoplasma pneumoniae, and Borrelia burgdorferi ) and viruses (i.e., herpes simplex virus, Epstein-Barr virus, influenza A, adenovirus, echovirus, the flavovirus that causes Japanese encephalitis, poliovirus, cytomegalovirus, and varicella-zoster virus), 1,19-21 with fatal cases associated with infection with Epstein-Barr virus and chickenpox. 22,23 Enterovirus 71, though now viewed as one of the chief causes of acute flaccid paralysis after the worldwide effort to eradicate poliomyelitis, has not been seen as an important cause of rhombencephalitis. Although many types of viral brain-stem encephalitis are characteristically sporadic, self-limited, and reversible, 1 enterovirus 71 rhombencephalitis is potentially epidemic and fatal.…”

Section: Discussionmentioning

confidence: 99%

Neurologic Complications in Children with Enterovirus 71 Infection

et al. 1999

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“…1 Most often changes occur supratentorially but occasionally the posterior fossa (pons-cerebellum) is primarily involved. [2][3][4] This is what occurred in our patient. The supratentorial findings were not as profound as the infratentorial, pontine, and parapontine findings (Fig.…”

Section: Discussionmentioning

confidence: 55%

Acute Ataxia in an Infant

Swischuk¹

2005

Pediatric Emergency Care

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CASEThis 18-month-old boy, previously healthy, except for recurrent bouts of otitis media, suddenly, one afternoon, started to stagger and weave while walking. Very quickly, this became worse and he then developed a left facial droop with some drooling. In addition, the mother noticed that he could not focus on her with his eyes and then she became quite concerned. All of this happened within a few hours.She took the infant to her local emergency room where the patient was evaluated. At that institution, a CT study of the brain without contrast was interpreted as being normal. The white blood cell count was 12,400 with 43% neutrophils, 45% lymphocytes, 1% monocytes, and 1% eosinophils. A urinalysis was negative and an attempted spinal tap revealed a bloody tap. Thereafter, the patient was referred to our emergency room (ER). In our ER, the previously noted neurologic deficits were substantiated and no new ones were detected. The patient did indeed stumble while walking, and for certain, had a left facial droop. At the same time, the patient was relatively coherent and would respond to commands, questions, and so forth. Repeat laboratory investigation substantiated the results from the incoming hospital.Prior to this episode, and as previously noted, the patient was healthy except for repeated bouts of otitis media. However, the patient fell at dayschool the day before and hit his right cheek. The patient also had another fall at home on a carpeted floor. None of these episodes were reflective of major trauma, and thus could be dismissed as significant factors.On arrival to our ER, the patient's heart rate was 135 per minute and regular, the blood pressure 110/62, the temperature 36.58C, and the respiratory rate was 38 and regular. Physical examination was normal except for those findings referable to the central nervous system. These findings were exactly the same as those elicited in the patient's home emergency room.A repeat spinal tap revealed a glucose level of 65 mg%, a total protein level of 61 mg%, a white blood cell count of 165 with a differential of 8% segmented neutrophils, 29% lymphocytes, 6 atypical lymphocytes, and 56% monocytes. Various clinical consultations were obtained, blood was sent off for evaluation for any abnormal aminoacidurias or other metabolic abnormalities, and an MR study of the brain was obtained (Fig. 1). What do you think the diagnosis might be in this patient? Radiology in the ED

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Fatal brainstem encephalitis caused by Epstein-Barr virus

Cited by 24 publications

References 4 publications

Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

Neurologic Complications in Children with Enterovirus 71 Infection

Acute Ataxia in an Infant

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