title: Unusual MRI findings in an immunocompetent patient with EBV encephalitis: a case report.
abstract: BACKGROUND
  It is well-known that Epstein-Barr virus (EBV) can affect the central nervous system (CNS).
  
  
  METHODS
  Herein the authors report unusual timely Magnetic Resonance Imaging (MRI) brain scan findings in an immunocompetent patient with EBV encephalitis. Diffusion weighted MRI sequence performed during the acute phase of the disease was normal, whereas the Fast Relaxation Fast Spin Echo T2 image showed diffuse signal intensity changes in white matter. The enhancement pattern suggested an inflammatory response restricted to the brain microcirculation. Acyclovir and corticosteroid therapy was administered. After three weeks, all signal intensities returned to normal and the patient showed clinical recovery.
  
  
  CONCLUSIONS
  This report demonstrates that EBV in an immunocompetent adult can present with diffuse, reversible brain white matter involvement in the acute phase of mononucleosis. Moreover, our case suggests that a negative DWI sequence is associated with a favorable improvement in severe EBV CNS infection. More extensive studies are needed to assess what other instrumental data can help to distinguish viral lesions from other causes in the acute phase of disease.
authors: Dipartimento di Scienze per la Promozione della Salute, Università di Palermo, Italy. pdicarlo@unipa.it
authors: Paola
authors: P
authors: Di Carlo
authors: Marcello
authors: M
authors: Trizzino
authors: Lucina
authors: L
authors: Titone
authors: Giuseppina
authors: G
authors: Capra
authors: Piero
authors: P
authors: Colletti
authors: Giovanni
authors: G
authors: Mazzola
authors: Daniela
authors: D
authors: Pistoia
authors: Caterina
authors: C
authors: Sarno
mesh_terms: D000328:Adult; D004660:Encephalitis / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D007244:Infectious Mononucleosis / Q000276:immunology* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male