Meningo encephalitis with Epstein-Barr virus in an immunocompetent adult patient: case report

Epstein-Barr virus is a rare ethology of the neurological infections, expressed as encephalitis, aseptic meningitis, Guillain-Barre syndrome or acute demyelinating encephalomyelitis. Most common cases were reported in children, while this infection is rarely described in immunocompetent adults. We p...

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Bibliographic Details
Main Authors: Sabina-Lucia Ganea, Manuela Arbune, Daniela-Renata Santea, Catalina-Elena Radu, Anca-Adriana Arbune
Format: Article
Language:English
Published: Amaltea Medical Publishing House 2023-03-01
Series:Romanian Journal of Infectious Diseases
Subjects:
Online Access:https://rjid.com.ro/articles/2023.1/RJID_2023_1_Art-03.pdf
Description
Summary:Epstein-Barr virus is a rare ethology of the neurological infections, expressed as encephalitis, aseptic meningitis, Guillain-Barre syndrome or acute demyelinating encephalomyelitis. Most common cases were reported in children, while this infection is rarely described in immunocompetent adults. We present the case of an elderly immunocompetent patient with hypertension and hypothyroidism under treatment who has presented to the emergency department for unusual headache, confusion, sudden loss of consciousness with retrograde amnesia, suddenly onset for 2 hours associated with febrile respiratory symptoms. Traumatic neurological events, cerebral ischemia or metabolic encephalopathies were ruled out, while examination of the cerebrospinal fluid was positive for EpsteinBarr virus. The course of the meningoencephalitis was favourable, although an episode of diarrhoea with Clostridioides difficile with binary positive toxin A+B was notified. The primary infection or the reactivation of a previous infection, is a questionable mechanism of meningoencephalitis with Epstein-Barr virus in an old immunocompetent patient. According to the reported studies, the antiviral treatment with Acyclovir is controversial. The long-term prognosis of acute meningoencephalitis with Epstein-Barr virus is unpredictable and involves careful neurological and onco-haematological monitoring.
ISSN:1454-3389
2069-6051