Epstein-Barr virus encephalitis presenting with a tumor-like lesion in an immunosuppressed transplant recipient

J Neurovirol. 2008 Nov;14(6):574-8. doi: 10.1080/13550280802345715.

Abstract

Epstein-Barr virus (EBV) associated central nervous system (CNS) infection is a rare disease. We report an atypical manifestation of EBV encephalitis initially presenting with a tumor-like lesion of the optic tract in an immunocompromised patient 8 years after a combined kidney and pancreas transplantation had been performed. Polymerase chain reaction (PCR) in the cerebrospinal fluid (CSF) and antibody testing confirmed the diagnosis of EBV encephalitis, most likely as a consequence of a reactivated persistent EBV infection. After cessation of the immunosuppressive therapy and induction of treatment with ganciclovir, clinical and magnetic resonance imaging (MRI) findings rapidly improved.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / surgery
  • DNA, Viral / blood
  • DNA, Viral / cerebrospinal fluid
  • Diagnosis, Differential
  • Encephalitis, Viral / diagnosis*
  • Encephalitis, Viral / drug therapy
  • Epstein-Barr Virus Infections / diagnosis*
  • Epstein-Barr Virus Infections / drug therapy
  • Epstein-Barr Virus Infections / pathology
  • Female
  • Ganciclovir / therapeutic use
  • Glioma / diagnosis
  • Glioma / surgery
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / immunology
  • Magnetic Resonance Imaging
  • Middle Aged
  • Pancreas Transplantation / adverse effects
  • Pancreas Transplantation / immunology
  • Visual Pathways / pathology
  • Withholding Treatment

Substances

  • Antiviral Agents
  • DNA, Viral
  • Immunosuppressive Agents
  • Ganciclovir