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