Department of Medicine, Division of Infectious Diseases, Helsinki University Central Hospital, HUS, Helsinki, Finland.
BMC Infect Dis. 2011 Oct 21;11:281. doi: 10.1186/1471-2334-11-281.
The role of Epstein-Barr (EBV) virus in central nervous system (CNS) infections is not fully resolved. It is clearly associated with lymphoproliferative disease of immunosuppressed persons, and may cause encephalitis.
We reviewed the medical records, imaging and laboratory findings of all patients EBV DNA PCR positive in cerebrospinal fluid (CSF) during 2000 to 2009 in the Helsinki University Central Hospital.
We identified 32 patients with EBV DNA in CSF. 11 had history of allogeneic hematopoietic stem cell transplantation, 7 solid organ transplantation and 5 HIV/AIDS. 5 patients had no preceding immunodeficiency.In 8 of the cases, another pathogen was identified in CSF. These were M. tuberculosis (2), T. gondii (2), Aspergillus (1), Herpes simplex virus 1 (1), C. neoformans (1) and Human herpesvirus 6 (1). Altogether in 15/32 (47%) of the cases the clinician had a strong suspicion of cause other than EBV for the patients' CNS symptoms/findings.Of note, 7 of 11 (64%) patients with stem cell transplantation had encephalitis (univariate odds ratio 5.6; confidence Interval 1.1-27.4). Of these 6 had no other pathogen identified.
EBV DNA was often found together with other microbial findings in CSF of immunocompromised patients. EBV seems to be associated with encephalitis in stem cell transplant recipients.
EB 病毒（EBV）在中枢神经系统（CNS）感染中的作用尚未完全阐明。它与免疫抑制人群的淋巴组织增生性疾病明显相关，并且可能导致脑炎。
我们回顾了 2000 年至 2009 年期间在赫尔辛基大学中心医院脑脊液（CSF）中 EBV DNA PCR 阳性的所有患者的病历、影像学和实验室检查结果。
我们确定了 32 例 CSF 中 EBV DNA 的患者。11 例有同种异体造血干细胞移植史，7 例有实体器官移植史，5 例有 HIV/AIDS。5 例患者无先前免疫缺陷。在 8 例患者中，CSF 中还发现了另一种病原体。这些病原体包括结核分枝杆菌（2 例）、刚地弓形虫（2 例）、曲霉（1 例）、单纯疱疹病毒 1 型（1 例）、新型隐球菌（1 例）和人类疱疹病毒 6 型（1 例）。总的来说，在 32 例患者中的 15 例（47%）中，临床医生强烈怀疑患者 CNS 症状/发现的原因不是 EBV。值得注意的是，11 例干细胞移植患者中有 7 例（64%）患有脑炎（单因素优势比 5.6；95%置信区间 1.1-27.4）。其中 6 例未发现其他病原体。
免疫抑制患者的 CSF 中 EBV DNA 常与其他微生物发现一起存在。EBV 似乎与干细胞移植受者的脑炎有关。
