Atrasheuskaya A V, Kameneva S N, Neverov A A, Ignatyev G M
Institute of Molecular Biology, State Research Center of Virology and Biotechnology Vector, Koltsovo, Novosibirsk region 630559, Russia.
J Clin Virol. 2004 Oct;31(2):160-4. doi: 10.1016/j.jcv.2004.03.007.
Both Epstein-Barr and measles viruses (MV) cause immune suppression, and the association of the two viruses is evaluated as life threatening. The cell immune impairment caused by simultaneous Epstein-Barr and measles viral infections was responsible for the complicated course of the disease in all described previously reports and for unfavorable outcomes in most of the cases. Timely diagnosis of coincidental viral infections could be a useful predictor for the clinical course and complications. Diagnosis must be based on an accurate assessment of clinical, hematologic, serologic manifestations and supported by appropriate laboratory methods. Recognizing the infectious etiology of concomitant infections is important for both clinicians and epidemiologists.
To describe a case report of a 20-year-old woman previously vaccinated against measles infected with acute mononucleosis and coincidental measles virus infection.
The clinical, routine laboratory, as well as serological and virologic findings of this patient were scrutinized. Special emphasis was placed on the use of RT-PCR/PCR for confirming the involvement of both measles virus and Epstein-Barr virus (EBV) in this patient's illness.
Infectious mononucleosis was not suspected at admission to the hospital. The final diagnosis of a concomitant measles virus infection and acute infectious mononucleosis was facilitated using viral serology to detect virus-specific IgG and IgM antibodies and by RT-PCR for the detection of measles virus RNA and EBV DNA from peripheral blood monocyte cells (PBMC).
The present report highlights the difficulty of diagnosing two coincidental virus infections on clinical grounds. Serological and molecular laboratory methods, specifically the PCR (RT-PCR) analysis, are found to be useful for confirming the concomitant viral infections and proper identification of the infecting pathogens.
爱泼斯坦-巴尔病毒（EB病毒）和麻疹病毒（MV）均可导致免疫抑制，两种病毒共同感染被认为有生命危险。既往所有报道中，EB病毒和麻疹病毒同时感染所致的细胞免疫损伤是疾病病程复杂及多数病例预后不良的原因。及时诊断合并病毒感染对临床病程及并发症而言可能是一项有用的预测指标。诊断必须基于对临床、血液学、血清学表现的准确评估，并辅以适当的实验室方法。认识合并感染的感染病因对临床医生和流行病学家均很重要。
描述一例曾接种麻疹疫苗的20岁女性感染急性单核细胞增多症并合并麻疹病毒感染的病例报告。
对该患者的临床、常规实验室检查以及血清学和病毒学检查结果进行了仔细研究。特别强调了使用逆转录聚合酶链反应/聚合酶链反应（RT-PCR/PCR）来确认麻疹病毒和爱泼斯坦-巴尔病毒（EBV）均与该患者疾病有关。
入院时未怀疑传染性单核细胞增多症。通过病毒血清学检测病毒特异性IgG和IgM抗体，以及通过RT-PCR从外周血单核细胞（PBMC）中检测麻疹病毒RNA和EBV DNA，最终诊断为合并麻疹病毒感染和急性传染性单核细胞增多症。
本报告强调了基于临床诊断两种合并病毒感染的困难。血清学和分子实验室方法，特别是PCR（RT-PCR）分析，被发现有助于确认合并病毒感染并正确识别感染病原体。
