title: Successful outcome of Epstein-Barr virus encephalitis managed with bilateral craniectomy, corticosteroids and aciclovir.
abstract: We present a 19-year-old woman with severe encephalitis and raised intracranial pressure requiring decompressive craniectomy. Her clinical features were consistent with encephalitis in the context of acute primary Epstein-Barr virus (EBV) infection (infectious mononucleosis). Serology, bone marrow aspirate and PCR of blood and cerebrospinal fluid confirmed the diagnosis. She was treated with corticosteroids and aciclovir. She was critically unwell for 3 weeks, requiring artificial ventilation but eventually made a good recovery. EBV encephalitis is uncommon, making the diagnosis and decisions about clinical management challenging.
authors.affiliation: Department of Microbiology, John Radcliffe Hospital, Oxford, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Hayton
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wakerley
authors.forename: Ian Cjw
authors.initials: IC
authors.lastname: Bowler
authors.forename: Marko
authors.initials: M
authors.lastname: Bogdanovic
authors.forename: Jane Elizabeth
authors.initials: JE
authors.lastname: Adcock
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage*; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000008:administration & dosage; D056424:Decompressive Craniectomy / Q000379:methods; D019468:Disease Management; D018792:Encephalitis, Viral / Q000175:diagnosis / Q000628:therapy*; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D000212:Acyclovir