Complicated EBV infection in a healthy child

Area of Science:

• Pediatrics
• Infectious Diseases
• Cardiology

Background:

• Epstein-Barr virus (EBV) is a common virus with generally benign outcomes.
• Primary EBV infections can occasionally lead to severe complications, particularly in children.

Observation:

• A previously healthy child presented with symptoms of tonsillitis and fever, initially treated with antibiotics.
• The child later developed fatigue, vomiting, abdominal pain, and was diagnosed with acute acalculous cholecystitis.
• Rapid deterioration occurred, leading to cardiogenic shock requiring intensive care and mechanical ventilation.

Findings:

• EBV serology confirmed a primary infection.
• The patient experienced two rare complications: acute acalculous cholecystitis and cardiogenic shock.
• Post-intensive care, the child exhibited moderate left ventricular dysfunction.

Implications:

• This case underscores the potential for severe, multi-systemic complications from primary EBV infection in children.
• It emphasizes the importance of considering EBV in pediatric patients presenting with unusual symptoms and complications.
• Early recognition and aggressive management are crucial for improving outcomes in severe EBV cases.