Polilli Ennio, Sozio Federica, Mazzotta Elena, Consorte Augusta, Di Masi Francesco, Agostinone Adriana, Tontodonati Monica, Cosentino Luana, Parruti Giustino
Infectious Disease Unit, Spirito Santo Hospital, Pescara, Italy.
New Microbiol. 2010 Jul;33(3):275-80.
Epstein-Barr virus (EBV) has been associated with primary central nervous system lymphoma and other EBV-related malignancies in HIV infected patients, and detection of EBV DNA in cerebrospinal fluid (CSF) by polymerase chain reaction (PCR) has been demonstrated to be a good marker of PCNSL. Conversely, EBV has been rarely associated with encephalitis in HIV patients. Here we describe for the first time the case of an HIV-infected, late presenter Caucasian man, diagnosed with a rapidly progressive diffuse encephalitis at presentation. A very high viral load for EBV was detected in CSF by PCR. The patient died 12 days after the onset of encephalitis in spite of supportive, antiviral and antiretroviral therapy. Our experience would suggest that in profoundly immunosuppressed HIV patients EBV may cause severe encephalitis in the absence of lymphoproliferative disorders.
爱泼斯坦-巴尔病毒（EBV）与HIV感染患者的原发性中枢神经系统淋巴瘤及其他EBV相关恶性肿瘤有关，通过聚合酶链反应（PCR）检测脑脊液（CSF）中的EBV DNA已被证明是原发性中枢神经系统淋巴瘤的良好标志物。相反，EBV在HIV患者中很少与脑炎相关。在此，我们首次描述了一例HIV感染的晚期白人男性病例，该患者在就诊时被诊断为快速进展性弥漫性脑炎。通过PCR在脑脊液中检测到非常高的EBV病毒载量。尽管进行了支持性、抗病毒和抗逆转录病毒治疗，该患者在脑炎发作12天后死亡。我们的经验表明，在免疫功能严重低下的HIV患者中，EBV可能在无淋巴增殖性疾病的情况下引起严重脑炎。
