title: Successful treatment of Epstein-Barr virus encephalitis in the setting of HIV-associated neurocognitive disorder: a diagnostic and therapeutic challenge.
abstract: We report a challenging case of HIV-associated neurocognitive disorder with superimposed Epstein-Barr virus (EBV) encephalitis. The patient presented with an abnormal MRI brain scan, and EBV DNA that was detected in the cerebrospinal fluid and brain biopsy, which also demonstrated histopathological findings consistent with the diagnosis. This occurred on the background of a 12-month period of gradual cognitive decrease secondary to HIV-associated dementia. Invasive testing was required to reach the diagnosis in this case, highlighting the importance of thorough investigation of neurological impairment in HIV-positive patients. Clinicopathological recovery was achieved through optimization of antiretroviral therapy and use of valganciclovir.
authors.affiliation: Infectious Diseases Department, Alfred Hospital, Melbourne, Australia. j.trevillyan@alfred.org.au
authors.forename: Janine M
authors.initials: JM
authors.lastname: Trevillyan
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Mahony
authors.forename: Catriona
authors.initials: C
authors.lastname: McLean
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Hoy
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology*; D018792:Encephalitis, Viral / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents