Related Experiment Videos
Epstein-Barr virus infection in a child with acquired immunodeficiency syndrome
Insights
This case study highlights a severe Epstein-Barr virus (EBV) infection in an infant. Delayed antibody response indicates DNA probes are crucial for diagnosing EBV in immunocompromised patients.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- A 3-year-old girl born to an intravenous-drug-dependent mother presented with failure to thrive and recurrent fevers.
- The infant exhibited persistent symptoms including diarrhea, lymphadenopathy, tachypnea, and pulmonary infiltrates within the first six months of life.
Observation:
- Epstein-Barr virus (EBV) genome was detected in saliva at 7 months via DNA dot-blot hybridization.
- Spontaneous EBV-positive lymphoblastoid cell lines developed from peripheral blood lymphocytes.
- Lung biopsy revealed lymphocytic infiltrates, with EBV genome identified in lung tissue.
Findings:
- Serum anti-EBV antibodies were undetectable until 14 months of age.
- The patient had a low T4+/T8+ ratio and antibodies to human T-cell lymphotropic virus type III (HTLV-III).
- Symptomatic EBV infection presented with a delayed seroresponse.
Implications:
- Reliance on EBV serology for diagnosing EBV in immunocompromised hosts may be unreliable.
- DNA probe methods are essential for accurate EBV diagnosis in immunocompromised individuals.
- This case underscores the importance of alternative diagnostic tools when serological responses are atypical.
Abstract:
A 3-year-old girl, born to an intravenous-drug-dependent mother, had protracted diarrhea, failure to thrive, generalized lymphadenopathy, and recurrent fevers during the first six months of life. At 7 months of age, the Epstein-Barr virus (EBV) genome was detected in her saliva by DNA dot-blot hybridization using a cloned EBV probe. Spontaneous EBV+ lymphoblastoid cell lines had repeatedly developed from her peripheral blood lymphocytes over the subsequent 2 1/2 years. At 11 months of age, persistent tachypnea and a diffuse pulmonary infiltrate developed. Lung biopsy demonstrated a florid, peribronchiolar lymphocytic infiltrate and the EBV genome was identified in the lung tissue. Serum anti-EBV antibodies remained undetectable until 14 months of age. She had a T4+/T8+ ratio of less than 0.8 and serum antibody to human T-cell lymphotropic virus type III. The delayed seroresponse of this patient to symptomatic EBV infection suggests that reliance on EBV serology to diagnose EBV infection in immunocompromised hosts may be inappropriate, and other methods such as DNA probes should be used.