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[Meningoencephalitis as the only manifestation of Epstein-Barr virus infection]
V Turkulov1, N Madle-Samardzija, S Brkić
1Klinicki centar, Medicinski fakultet, Novi Sad.
Introduction:
Epstein-Barr virus (EBV) infection is most often manifested as infective mononucleosis, which exhibits fever, tonsillopharyngitis, lymphadenopathy and hepatospleenomegaly, and presence of leucocytosis with lymphocytosis in the complete blood count. Neurological manifestations are rarely seen during EBV infection, in less than 1% of the diseased, most often under the features of serous meningitis, encephalitis, encephalomyelitis, transversal myelitis, neuritis, polyradiculoneuritis, convulsions etc.
Patients And Methods:
The aim of the study was to investigate the frequency and clinical features of neurological manifestations in EBV infected patients treated at the Clinic for Infectious Diseases. Clinical Centre Novi Sad, during 1997. Etiologic diagnosis was confirmed by establishing presence of the viral capsid antigen specific antibodies--EBV VCA, IgM and IgG class, in the blood and cerebro-spinal fluid, as well as according to the dynamics of their titre.
Results:
Most patients (94.64%), had the classic features exhibited by fever, angina, polylymphadenopathy and hepatospleenomegaly, while 5.36% of patients had neurological symptoms, that is meningoencephalitis as the only manifestation of EBV infection. Besides antibodies in sera, EBV antibodies in the cerebro-spinal fluid had been proved in these patients. In all patients, other viral etiology of meningoencephalitis had been excluded by serologic blood examination. Bacterial findings in the cerebro-spinal fluid had been negative as well. The outcome of the illness was favourable in all patients.
Insights
Neurological symptoms, including meningoencephalitis, are rare but documented manifestations of Epstein-Barr virus (EBV) infection. This study found these neurological signs occurred in 5.36% of EBV patients, with favorable outcomes.
Area of Science:
- Infectious Diseases
- Neurology
- Virology
Context:
- Epstein-Barr virus (EBV) commonly causes infectious mononucleosis.
- Neurological manifestations are rare complications of EBV infection, typically presenting as meningitis or encephalitis.
- This study focuses on the frequency and clinical presentation of neurological symptoms in EBV-infected patients.
Purpose:
- To investigate the incidence and clinical characteristics of neurological manifestations in patients with Epstein-Barr virus infection.
- To confirm EBV etiology in neurological cases through serological testing of blood and cerebrospinal fluid.
- To differentiate EBV-related neurological illness from other infectious causes.
Summary:
- The study identified neurological symptoms, specifically meningoencephalitis, in 5.36% of EBV-infected patients.
- EBV viral capsid antigen (VCA) IgM and IgG antibodies were detected in serum and cerebrospinal fluid of affected patients.
- All neurological cases were confirmed as EBV-related after excluding other viral and bacterial etiologies, with all patients experiencing a favorable outcome.
Impact:
- Highlights the importance of considering EBV as a potential cause of neurological symptoms, even when classic mononucleosis signs are absent.
- Provides data on the frequency and clinical presentation of EBV-associated meningoencephalitis.
- Confirms the generally favorable prognosis of neurological manifestations in EBV infection.