Epstein-Barr viral load assessment in immunocompetent patients with fulminant infectious mononucleosis.
We describe 2 immunocompetent adolescents with fulminant infectious mononucleosis and virus-associated hemophagocytosis. A new quantitative polymerase chain reaction revealed high serum Epstein-Barr virus DNA levels in these patients. One patient died with an increasing viral load not responding to corticosteroids followed by antiviral and intensified immunomodulatory treatment. The other patient received corticosteroids and acyclovir at diagnosis; her rapid recovery was heralded by a steep decline of viral load. We propose monitoring the clinical course of fulminant infectious mononucleosis in immunocompetent patients by Epstein-Barr virus DNA quantification and prompt corticosteroid and antiviral therapy when viral load is high.
van Laar
Jan A M
JA
Department of Oncology, Groene Hilledijk 301, 3075 EA Rotterdam, the Netherlands. vanlaar@inw1.azr.nl
Buysse
Corinne M P
CM
Vossen
Ann C T M
AC
Hjálmarsson
Björn
B
van Den Berg
Bart
B
van Lom
Kirsten
K
Deinum
Jaap
J
D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007108:Immune Tolerance; D007244:Infectious Mononucleosis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D010198:Pancytopenia / Q000209:etiology; D016133:Polymerase Chain Reaction / Q000379:methods; D011239:Prednisolone / Q000627:therapeutic use; D019562:Viral Load
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D011239:Prednisolone; D000212:Acyclovir