Psychiatric symptoms and cognitive dysfunction caused by Epstein–Barr virus-induced encephalitis

Abstract

Epstein-Barr virus (EBV) encephalitis is rare and shows a wide range of clinical manifestations. We report an immunocompromised patient with EBV encephalitis diagnosed by EBV-specific PCR and antibody testing in the cerebrospinal fluid who presented with psychiatric symptoms and cognitive dysfunction in the absence of any neurological impairments or infectious signs. Clinical recovery and clearance of cerebrospinal fluid EBV DNA appeared following ganciclovir treatment within 6 weeks.

Molecular monitoring and stepwise preemptive therapy for Epstein–Barr virus viremia after allogeneic stem cell transplantation

“…CMV is the most dreadful until prophylactic and preemptive strategies are developed after the approval of modern antiviral agents, but there is still lack of effective preventive and therapeutic drugs for EBV. Both primary EBV infection and reactivation may result in life‐threatening diseases in recipients of allo‐SCT, which can present as a variety of clinical symptoms and signs, such as viremia, fever, mononucleosis‐like illness, encephalitis/myelitis, pneumonia, and posttransplant lymphoproliferative disease (PTLD) . EBV‐associated diseases progress rapidly and are associated with a mortality of more than 90% if not treated at an early stage .…”

Epstein–Barr virus encephalitis in a renal transplant recipient manifesting as hemorrhagic, ring‐enhancing mass lesions

“…EBV accounts for between 1% and 6% of cases of encephalitis, and has classically been described in children and young adults as a complication of infectious mononucleosis . EBV encephalitis has only occasionally been described in immunocompromised patients including those with human immunodeficiency virus (HIV) , corticosteroid use , solid organ transplantation (almost exclusively renal transplantation) , and bone marrow transplantation . In these patients, EBV encephalitis is usually the result of reactivation rather than primary infection .…”

“…Epstein–Barr virus (EBV) encephalitis has classically been described in children and young adults as a complication of infectious mononucleosis , and has only occasionally been described in immunocompromised patients . The diagnosis is challenging given the lack of specificity of cerebrospinal fluid (CSF) EBV polymerase chain reaction (PCR) in immunocompromised patients.…”

Epstein–Barr virus (EBV) load in cerebrospinal fluid and peripheral blood of patients with EBV‐associated central nervous system diseases after allogeneic hematopoietic stem cell transplantation

“…However, EBV infection and reactivation may result in life‐threatening diseases in immunocompromised people . EBV infection or reactivation can present as a variety of clinical symptoms and signs, such as viremia, fever, lymphadenopathy, mononucleosis‐like illness, encephalomyelitis, pneumonia, and rapidly aggressive lymphoma in recipients of allo‐HSCT . Post‐transplant EBV‐associated central nervous system (CNS) diseases, such as encephalitis/myelitis and lymphoproliferative diseases, are acute complications and have a wide range of clinical manifestations.…”