A rare case of fulminant primary Epstein-Barr virus infection in a young adult

Introduction: Primary Epstein-Barr virus (EBV) infection usually manifests in adolescents and young adults as infectious mononucleosis which classically presents as a syndrome of fever, pharyngitis, lymphadenopathy, fatigue and atypical lymphocytosis. The vast majority of patients have relatively mild disease. However, it may rarely present as a fulminant infection with severe multi-organ manifestations. Case Report: We report a rare case of a young woman admitted under our care in hospital with severe primary EBV infection. A 20-yearold female with no significant past medical history presented with a three-week history of worsening sore throat, ear pain, non-productive cough, fever, nausea, generalized myalgia and lethargy. Serology confirmed that she had acute EBV infection. During her admission, she developed complications of fulminant hepatic failure, coagulopathy, retropharyngeal abscess, ulcerative glossitis and pulmonary consolidation resulting in hemoptysis and sepsis which required intensive care unit management. With aggressive antibiotic and supportive therapy, she made a full recovery. Conclusion: This is the first case report documenting the concurrent presence of severe multi-system involvement in primary EBV infection including hepatic, haematological, upper and lower respiratory tract. Despite the benign course of disease in the vast majority of patients with primary EBV infection, this case highlights the need for clinicians to be aware of the possibility of fulminant disease with severe multi-organ involvement with potential lifethreatening consequences. Clinicians treating patients with primary EBV infection should remain vigilant in monitoring and treating severe complications.

並列關鍵字

Coagulopathy ； Epstein-Barr virus ； Haemoptysis ； Infection ； Liver failure ； Retropharyngeal abscess

國際替代計量

全文下載

主題瀏覽