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Persistent high fever and gall-bladder wall thickening in a child with primary Epstein-Barr viral infection
1Department of Paediatrics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT.
Insights
Primary Epstein-Barr viral infection can cause significant liver issues in children, including hepatomegaly and biliary obstruction. Prompt diagnosis and supportive care led to full recovery in this pediatric case.
Area of Science:
- Pediatrics
- Virology
- Hepatology
Background:
- Epstein-Barr virus (EBV) is a common human herpesvirus.
- While typically causing infectious mononucleosis, EBV can present with atypical symptoms in children.
- Hepatobiliary manifestations of EBV infection require careful consideration in pediatric diagnostics.
Observation:
- A 3.5-year-old girl presented with prolonged fever, rigors, and cough.
- Physical exam revealed hepatomegaly, with abnormal liver function tests suggesting biliary obstruction.
- Abdominal ultrasound showed a distended gallbladder with thickened walls.
Findings:
- Specific serological studies confirmed a primary Epstein-Barr viral infection.
- The patient's symptoms resolved with supportive care.
- Liver function tests normalized within one month.
Implications:
- This case highlights EBV as a potential cause of pediatric hepatobiliary dysfunction.
- Early recognition of EBV-associated liver disease is crucial for timely management.
- Further research into the spectrum of EBV-related hepatic complications in children is warranted.
Abstract:
A 3.5 year old girl presented with a history of high fever, rigors, and mild cough for 1 week. Physical examination revealed normal chest findings but gross hepatomegaly was detected. Liver function tests were abnormal and indicated biliary obstruction. Ultrasonography revealed a distended gall-bladder with increased wall thickness up to 0.6 cm. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serological study. The patient's fever subsided 2 weeks later and her liver function tests returned to normal 1 month later. Abdominal ultrasonography at this time was normal.