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Severe respiratory insufficiency complicating Epstein-Barr virus infection: case report and review
A Haller1, L von Segesser, P C Baumann
1Department of Internal Medicine, University Hospital of Zurich, Switzerland.
Insights
A severe Epstein-Barr virus (EBV) infection caused life-threatening lung inflammation in a young adult. Prompt treatment with corticosteroids and advanced respiratory support led to survival without lasting effects.
Area of Science:
- Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Infectious mononucleosis, commonly caused by Epstein-Barr virus (EBV), typically presents with mild symptoms.
- Severe pulmonary complications, such as bilateral pneumonitis, are rare but serious manifestations of acute EBV infection.
Observation:
- A young adult presented with life-threatening bilateral pneumonitis during acute Epstein-Barr virus infection.
- The patient experienced severe hypoxemia, necessitating mechanical ventilation and intravascular oxygenation.
Findings:
- Corticosteroid therapy was initiated for the severe pneumonitis.
- The patient recovered fully without any long-term sequelae from the pulmonary involvement.
Implications:
- This case highlights that severe pulmonary disease is a potential, albeit rare, complication of Epstein-Barr virus infection.
- Early recognition and aggressive management, including corticosteroids and advanced respiratory support, are crucial for favorable outcomes in EBV-associated pneumonitis.
Abstract:
We report a case involving a young adult who had life-threatening bilateral pneumonitis in the course of an acute Epstein-Barr virus (EBV) infection. Because of severe hypoxemia, the patient required mechanical ventilation and additional oxygenation by an intravascular oxygenator. The patient was treated with corticosteroids and survived without sequelae. Severe pulmonary involvement associated with EBV infection is a rare but potentially fatal complication of infectious mononucleosis. Similar cases reported in the literature are reviewed, and the therapeutic options for this particular complication are discussed.