Epstein-Barr virus encephalitis presenting with a tumor-like lesion in an immunosuppressed transplant recipient.
Epstein-Barr virus (EBV) associated central nervous system (CNS) infection is a rare disease. We report an atypical manifestation of EBV encephalitis initially presenting with a tumor-like lesion of the optic tract in an immunocompromised patient 8 years after a combined kidney and pancreas transplantation had been performed. Polymerase chain reaction (PCR) in the cerebrospinal fluid (CSF) and antibody testing confirmed the diagnosis of EBV encephalitis, most likely as a consequence of a reactivated persistent EBV infection. After cessation of the immunosuppressive therapy and induction of treatment with ganciclovir, clinical and magnetic resonance imaging (MRI) findings rapidly improved.
Khalil
Michael
M
Department of Neurology, Medical University Graz, Graz, Austria. Medical University Graz, Graz, Austria
Enzinger
Christian
C
Wallner-Blazek
Mirja
M
Scarpatetti
Michael
M
Barth
Alain
A
Horn
Sabine
S
Reiter
Gudrun
G
D000998:Antiviral Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery; D004279:DNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D003937:Diagnosis, Differential; D018792:Encephalitis, Viral / Q000175:diagnosis* / Q000188:drug therapy; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D005910:Glioma / Q000175:diagnosis / Q000601:surgery; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000276:immunology; D014795:Visual Pathways / Q000473:pathology; D028761:Withholding Treatment
D000998:Antiviral Agents; D004279:DNA, Viral; D007166:Immunosuppressive Agents; D015774:Ganciclovir