1. Clinical significance of Epstein-Barr virus in the cerebrospinal fluid of immunocompetent patients.
- Author
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Lee GH, Kim J, Kim HW, and Cho JW
- Subjects
- Adult, Aged, Coinfection, Cytomegalovirus Infections cerebrospinal fluid, Cytomegalovirus Infections complications, Cytomegalovirus Infections physiopathology, Encephalitis, Herpes Simplex cerebrospinal fluid, Encephalitis, Herpes Simplex complications, Encephalitis, Herpes Simplex physiopathology, Encephalitis, Viral cerebrospinal fluid, Encephalitis, Viral complications, Encephalitis, Viral physiopathology, Enterococcus faecalis, Epstein-Barr Virus Infections cerebrospinal fluid, Epstein-Barr Virus Infections complications, Female, Gram-Positive Bacterial Infections cerebrospinal fluid, Gram-Positive Bacterial Infections complications, Gram-Positive Bacterial Infections physiopathology, Guillain-Barre Syndrome cerebrospinal fluid, Guillain-Barre Syndrome complications, Guillain-Barre Syndrome physiopathology, Humans, Infectious Encephalitis cerebrospinal fluid, Infectious Encephalitis complications, Infectious Encephalitis microbiology, Intensive Care Units, Intracranial Hypotension cerebrospinal fluid, Intracranial Hypotension complications, Intracranial Hypotension physiopathology, Male, Meningitis cerebrospinal fluid, Meningitis complications, Meningitis microbiology, Meningitis, Pneumococcal cerebrospinal fluid, Meningitis, Pneumococcal complications, Meningitis, Pneumococcal physiopathology, Meningitis, Viral cerebrospinal fluid, Meningitis, Viral complications, Meningitis, Viral physiopathology, Middle Aged, Optic Neuritis cerebrospinal fluid, Optic Neuritis complications, Optic Neuritis physiopathology, Streptococcal Infections cerebrospinal fluid, Streptococcal Infections complications, Streptococcal Infections physiopathology, Streptococcus pneumoniae, Varicella Zoster Virus Infection cerebrospinal fluid, Varicella Zoster Virus Infection complications, Varicella Zoster Virus Infection physiopathology, DNA, Viral cerebrospinal fluid, Epstein-Barr Virus Infections physiopathology, Herpesvirus 4, Human genetics, Immunocompetence, Infectious Encephalitis physiopathology, Meningitis physiopathology
- Abstract
Introduction: Polymerase chain reaction (PCR)-based testing of cerebrospinal fluid (CSF) samples has greatly facilitated the diagnosis of central nervous system (CNS) infections. However, the clinical significance of Epstein-Barr virus (EBV) DNA in CSF of individuals with suspected CNS infection remains unclear. We wanted to gain a better understanding of EBV as an infectious agent in immunocompetent patients with CNS disorders., Methods: We identified cases of EBV-associated CNS infections and reviewed their clinical and laboratory characteristics. The study population was drawn from patients with EBV PCR positivity in CSF who visited Pusan National University Hospital between 2010 and 2019., Results: Of the 780 CSF samples examined during the 10-year study period, 42 (5.4 %) were positive for EBV DNA; 9 of the patients (21.4 %) were diagnosed with non-CNS infectious diseases, such as optic neuritis, Guillain-Barré syndrome, and idiopathic intracranial hypotension, and the other 33 cases were classified as CNS infections (22 as encephalitis and 11 as meningitis). Intensive care unit admission (13/33 patients, 39.3 %) and presence of severe neurological sequelae at discharge (8/33 patients, 24.2 %) were relatively frequent. In 10 patients (30.3 %), the following pathogens were detected in CSF in addition to EBV: varicella-zoster virus (n = 3), cytomegalovirus (n = 2), herpes simplex virus 1 (n = 1), herpes simplex virus 2 (n = 1), Streptococcus pneumomiae (n = 2), and Enterococcus faecalis (n = 1). The EBV-only group (n = 23) and the co-infection group (n = 10) did not differ in age, gender, laboratory data, results of brain imaging studies, clinical manifestations, or prognosis; however, the co-infected patients had higher CSF protein levels., Conclusion: EBV DNA in CSF is occasionally found in the immunocompetent population; the virus was commonly associated with encephalitis and poor prognosis, and frequently found together with other microbes in CSF., (Copyright © 2021 Elsevier B.V. All rights reserved.)
- Published
- 2021
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