title: Hypersensitivity to mosquito bites as the primary clinical manifestation of an Epstein-Barr virus infection.
abstract: Hypersensitivity to mosquito bites (HMB) is a rare disease characterized by intense local skin reactions with general symptoms, such as high fever and regional lymphadenopathy after mosquito bites. Epstein-Barr virus (EBV) chronic infection and NK cell lymphoproliferative disease have been reported first in diagnosed HMB patients. Here, we present the case of a 6-year-old girl with 2 months' history of bullae and necrotic skin lesions, accompanied by a high temperature, visual hallucinations, and liver dysfunction after mosquito bites. A histopathologic examination of the skin lesion showed vasculitis and EBV infection. We could not detect any findings of hematologic malignancies or NK cell proliferative disease in the patient. Clinicians should closely evaluate HMB patients for possible development of lymphoproliferative status or hematologic malignant disorders.
authors.affiliation: Department of Dermatology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Tsu-Man
authors.initials: TM
authors.lastname: Chiu
authors.affiliation: Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Yueh-Min
authors.initials: YM
authors.lastname: Lin
authors.affiliation: Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Shing-Chuang
authors.initials: SC
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; School of Medicine, Kaohsiung Medicial University, Kaohsiung, Taiwan. Electronic address: 107239@cch.org.tw.
authors.forename: Yi-Giien
authors.initials: YG
authors.lastname: Tsai
mesh_terms: D000818:Animals; D002648:Child; D009033:Culicidae; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology* / Q000473:pathology; D007299:Insect Bites and Stings / Q000276:immunology* / Q000473:pathology*; D000072281:Lymphadenopathy / Q000821:virology; D012867:Skin / Q000473:pathology
keywords: Epstein–Barr virus; Hypersensitivity