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Published on: March 30, 2018
Fatal Epstein-Barr virus infection in an immunocompetent host: a postmortem diagnosis
Aniello Maiese1, Raffaele La Russa2, Giovanna Passaro3
1Section of Legal Medicine, Department of Surgical Pathology, Medical, Molecular and Critical Area, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
Abstract:
Meningoencephalitis is the most common neurological complication related to Epstein-Barr virus (EBV), and in immunocompetent adults, it is most commonly self-limited. We describe a case of fatal EBV infection characterized by meningoencephalitis, foci of myocarditis and interstitial nephritis in an immunocompetent 74-year-old man. The postmortem diagnosis was made based on the presence of EBV DNA in the cerebrospinal fluid and by immunohistochemical assay that showed spots of intracellular positivity to anti-EBV antibody in brain tissue.
Insights
Epstein-Barr virus (EBV) can cause meningoencephalitis, typically self-limiting in healthy adults. This case highlights a rare fatal EBV infection with widespread organ involvement, including the brain, heart, and kidneys, in an immunocompetent elderly man.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Meningoencephalitis is a frequent neurological complication of Epstein-Barr virus (EBV) infection.
- In immunocompetent adults, EBV-related meningoencephalitis is usually self-limiting.
Observation:
- A case study of a 74-year-old immunocompetent male patient is presented.
- The patient experienced a fatal EBV infection.
Findings:
- The fatal EBV infection was characterized by meningoencephalitis, myocarditis, and interstitial nephritis.
- Postmortem diagnosis was confirmed by detecting EBV DNA in cerebrospinal fluid and immunohistochemical analysis of brain tissue.
Implications:
- This case underscores the potential for severe, multi-organ EBV disease even in immunocompetent individuals.
- It highlights the importance of considering EBV in unexplained neurological and systemic complications.
- Advanced diagnostic techniques are crucial for confirming EBV involvement in fatal cases.
