title: Acute viral hepatitis presenting as cytomegalovirus, hepatitis E and Epstein-Barr virus IgM antibody positive.
abstract: We report a case of acute cytomegalovirus (CMV) infection with positive HEV and Epstein-Barr virus (EBV) serology. No patients have been reported positive for immunoglobulin (Ig)M antibodies to all three viruses. This patient had progressively increasing titres of IgM antibody for CMV, HEV and EBV. Only CMV DNA was detectable before antiviral treatment. After antiviral treatment, the patient recovered completely. At day 180 the CMV IgG test had converted to positive with CMV IgM (+), EBV IgM (-) and HEV IgM (-). Our report indicates that dependence upon serology alone is unreliable in the diagnosis of acute CMV, EBV and HEV infections. The diagnosis of CMV, HEV and EBV should be based on a combination of clinical features, serology and confirmatory PCR testing.
authors.affiliation: Department of Infectious Disease, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Huang
authors.forename: Xin-Hua
authors.initials: XH
authors.lastname: Li
authors.forename: Cuiyun
authors.initials: C
authors.lastname: Zhu
authors.forename: Jingjing
authors.initials: J
authors.lastname: Yan
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Song
authors.forename: Shuye
authors.initials: S
authors.lastname: Zhang
authors.forename: Yunwen
authors.initials: Y
authors.lastname: Hu
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.forename: Yun
authors.initials: Y
authors.lastname: Ling
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D003429:Cross Reactions; D003587:Cytomegalovirus / Q000276:immunology* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000276:immunology; D004279:DNA, Viral / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000276:immunology; D005189:False Positive Reactions; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D016751:Hepatitis E / Q000175:diagnosis / Q000276:immunology; D016752:Hepatitis E virus / Q000276:immunology*; D006525:Hepatitis, Viral, Human / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D012367:RNA, Viral / Q000097:blood
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D004279:DNA, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral; D015774:Ganciclovir