Abstract Details

Title Clinical Spectrum of Central Nervous System Infection by Epstein-Barr Virus in Immunocompetent Subjects: A Case Series

Topic Infectious Disease

Presentation(s) Infectious Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 029

Objective NA

Background Epstein-Barr virus is a human herpesvirus that cause a large spectrum of clinical manifestations and can occur associated to other disorders. This case series aims to show atypical cases of infection by Epstein-Barr virus affecting immunocompetent patients, presenting abnormalities in brain magnetic resonance imaging, and confirmed through cerebral biopsy.

Design/Methods Case 1 - Previously healthy 18-year-old male, presenting leg weakness, postural instability, slurred speech, and cerebellar atrophy. He had a complete genetic investigation negative for hereditary ataxias. Case 2 – A 79-year-old male evolving with hemiparesis and sensitive impairment on right upper and lower limbs. Initial MRI was suggestive of demyelinating disease. However, one month later, a control exam showed a lesion with high suspicion of glioblastoma. Case 3 – 55-year-old woman undergoing oncological follow-up for lymphoproliferative disease diagnosed in 2017, without evidence of activity, reporting gait ataxia, postural instability and motor incoordination predominantly in left upper limb evolving into 4 weeks. Case 4 – 60-year-old male, evolving with a rapidly progressive symptomatology characterized by behavioral changes, memory impairment, apathy, balance and gait disorder, urinary incontinence, and limitation on activities of daily living.

Results NA

Conclusions Epstein-Barr virus primary infection is a common disease, and over 90% of adult people worldwide is supposed to be infected. Neurological disorders as neuropathy, cerebellar ataxia, and myeloencephalitis are associated to infection by the virus; although acute Epstein-Barr virus cerebellitis is rare, in this case series three patients presented prominent cerebellar abnormalities. Furthermore, involvement of pons on magnetic resonance imaging and significant clinical /radiological improvement after specific antiviral treatment happened in all cases. Therefore, Epstein-Barr virus infection can present with a large spectrum of manifestations, including severe neurological syndromes, so a high clinical suspicion is important to provide an early diagnosis and treatment that may dramatically change the prognosis.

Authors/Disclosures
Rafael Gemaque Lima Bentes PRESENTER	Mr. Gemaque Lima Bentes has nothing to disclose.
William Souza Martins Ferreira (Hospital Beneficência Portuguesa de SP)	Mr. Souza Martins Ferreira has nothing to disclose.
Matheus Alves A. Silva, MD (Beneficiencia Portuguesa)	Dr. Silva has nothing to disclose.
Barbara M. Carvalho (Hospital BP - Beneficencia Portuguesa de São Paulo)	Miss Carvalho has nothing to disclose.
Victor Mantelatto Bonsi	Victor Mantelatto Bonsi has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Alex Baeta	Alex Baeta has nothing to disclose.

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Abstract Details