Epstein-Barr virus associated with primary CNS lymphoma and disseminated BCG infection in a child with AIDS.
BACKGROUND
AIDS patients are at increased risk of developing concurrent infections with viral, parasitic, fungal or mycobacterial organisms. They can present constitutional symptoms of fever and weight loss, either due to infections or an underlying lymphoma which may coexist.


METHODS
A child with HIV-AIDS and mild encephalopathy is reported, who during the course of a confirmed disseminated mycobacterial disease developed neurological impairment. Post-mortem examination revealed disseminated BCG infection and Epstein-Barr associated primary CNS lymphoma. Epstein-Barr virus (EBV) presence was assessed by LMP-1 protein labelling by immunohistochemistry and in situ hybridisation (ISH) for Epstein-Barr virus-encoded RNAs (EBERs) in formalin-fixed and paraffin-embedded sections.


CONCLUSIONS
BCG vaccination among HIV-1 infected children leads to the risk of disseminated BCG infection. BCG immunization programmes should be reconsidered for children at risk of HIV infection, because the risk of delayed complications is independent of the immunological status at the time of the vaccination. Only isolated cases of primary CNS lymphoma occurring in HIV-infected children have been reported, and a striking association with EBV infection has been demonstrated.
Fallo
Aurelia
A
AIDS Reference Center, Division of Pediatric Infectious Disease, Hospital de Niños Ricardo Gutiérrez (HNRG), Virrey Arredondo 3231, 1426, Buenos Aires, Argentina. afallo@intramed.net.ar
De Matteo
Elena
E
Preciado
María Victoria
MV
Cerqueiro
María Cristina
MC
Escoms
Susana
S
Chabay
Paola
P
López
Eduardo
E
D017088:AIDS-Related Opportunistic Infections; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D001500:BCG Vaccine / Q000009:adverse effects*; D001932:Brain Neoplasms / Q000209:etiology*; D002051:Burkitt Lymphoma / Q000209:etiology*; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D014376:Tuberculosis / Q000209:etiology*
D001500:BCG Vaccine