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BMC Infect Dis. 2011 Oct 21;11:281. doi: 10.1186/1471-2334-11-281.

Clinical characteristics of patients with Epstein Barr virus in cerebrospinal fluid.

Author information

1
Department of Medicine, Division of Infectious Diseases, Helsinki University Central Hospital, HUS, Helsinki, Finland. timi.martelius@hus.fi

Abstract

BACKGROUND:

The role of Epstein-Barr (EBV) virus in central nervous system (CNS) infections is not fully resolved. It is clearly associated with lymphoproliferative disease of immunosuppressed persons, and may cause encephalitis.

METHODS:

We reviewed the medical records, imaging and laboratory findings of all patients EBV DNA PCR positive in cerebrospinal fluid (CSF) during 2000 to 2009 in the Helsinki University Central Hospital.

RESULTS:

We identified 32 patients with EBV DNA in CSF. 11 had history of allogeneic hematopoietic stem cell transplantation, 7 solid organ transplantation and 5 HIV/AIDS. 5 patients had no preceding immunodeficiency.In 8 of the cases, another pathogen was identified in CSF. These were M. tuberculosis (2), T. gondii (2), Aspergillus (1), Herpes simplex virus 1 (1), C. neoformans (1) and Human herpesvirus 6 (1). Altogether in 15/32 (47%) of the cases the clinician had a strong suspicion of cause other than EBV for the patients' CNS symptoms/findings.Of note, 7 of 11 (64%) patients with stem cell transplantation had encephalitis (univariate odds ratio 5.6; confidence Interval 1.1-27.4). Of these 6 had no other pathogen identified.

CONCLUSIONS:

EBV DNA was often found together with other microbial findings in CSF of immunocompromised patients. EBV seems to be associated with encephalitis in stem cell transplant recipients.

PMID:
22018204
PMCID:
PMC3213057
DOI:
10.1186/1471-2334-11-281
[Indexed for MEDLINE]
Free PMC Article

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