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[Meningo-encephalitis and hydrocephalus caused by Epstein-Barr virus]
J M van der Klooster1, J L van Saase, A F Grootendorst
1Afd. Interne Geneeskunde en Intensive-caregeneeskunde, Sint Clara Ziekenhuis, Rotterdam.
Nederlands Tijdschrift Voor Geneeskunde
|June 12, 1998
Summary
Epstein-Barr virus (EBV) meningoencephalitis can cause severe neurological symptoms like hydrocephalus in adults. Prompt diagnosis and treatment with a shunt and ganciclovir led to full recovery in a rare adult case.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Epstein-Barr virus (EBV) is a common virus, typically causing infectious mononucleosis.
- Meningoencephalitis, inflammation of the brain and meninges, is a rare complication of EBV infection.
- While typically mild, EBV meningoencephalitis can present with severe neurological manifestations.
Observation:
- A 35-year-old woman presented with acute somnolence, confusion, and respiratory changes.
- Clinical signs included papilledema and bilateral abducens nerve palsy.
- Brain imaging revealed generalized cerebral edema and triventricular hydrocephalus.
Findings:
- Diagnosis of EBV meningoencephalitis was confirmed via serological testing and cerebrospinal fluid PCR.
- The patient developed hydrocephalus secondary to aqueduct stenosis, a complication not previously reported in adult EBV meningoencephalitis.
- Treatment involved a ventriculoperitoneal shunt and ganciclovir.
Implications:
- This case highlights the potential for severe neurological complications, including hydrocephalus, from EBV meningoencephalitis in adults.
- Early consideration of EBV meningoencephalitis is crucial when adult patients exhibit deteriorating neurological status or worsening symptoms.
- Successful management with CSF diversion and antiviral therapy suggests a viable treatment approach for this rare presentation.