Hemorrhagic encephalitis associated with Epstein-Barr virus infection.
Epstein-Barr virus (EBV) encephalitis is a rare neurological complication, usually only reported in pediatric patients. We present a 20-year-old, previously healthy male who developed hemorrhagic encephalitis caused by EBV. He was admitted to our hospital with a 1-week history of fever, diarrhea, headache, and confusion. Brain T2-weighted MRI showed a focal area of increased signal in the right temporal lobe. Brain MRI and CT scans on day 2 revealed progression of the lesion, with partial hemorrhagic change, acute brain swelling, and severe midline shift. The patient underwent external decompression and external ventricular drainage. EBV DNA was identified in brain biopsy specimens by polymerase chain reaction. The postoperative course was uneventful. To our knowledge, this is the second report of hemorrhagic EBV encephalitis in an adult.
Takeuchi
Satoru
S
Department of Neurosurgery, National Hospital Organization Disaster Medical Center, 3256 Midori-cho, Tachikawa-shi, Tokyo 190-0014, Japan. s.takeuchi@room.ocn.ne.jp
Takasato
Yoshio
Y
Masaoka
Hiroyuki
H
Hayakawa
Takanori
T
Otani
Naoki
N
Yoshino
Yoshikazu
Y
Yatsushige
Hiroshi
H
Sugawara
Takashi
T
D000208:Acute Disease; D000367:Age Factors; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D003221:Confusion / Q000209:etiology; D003399:Craniotomy; D004279:DNA, Viral / Q000235:genetics; D019299:Decompression, Surgical; D003967:Diarrhea / Q000209:etiology; D018450:Disease Progression; D018792:Encephalitis, Viral / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology*; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005334:Fever / Q000209:etiology; D006261:Headache / Q000209:etiology; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D004684:Leukoencephalitis, Acute Hemorrhagic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000821:virology*; D008279:Magnetic Resonance Imaging; D008297:Male; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014696:Ventriculostomy; D055815:Young Adult
D000998:Antiviral Agents; D004279:DNA, Viral