Mohsen Hassan, Abu Zeinah Ghaith Farid, Elsotouhy Ahmed Hassan, Mohamed Khalid
Weill Cornell Medical College in Qatar, Doha, Qatar.
BMJ Case Rep. 2013 Jul 10;2013:bcr2013010048. doi: 10.1136/bcr-2013-010048.
Symptomatic Epstein-Barr virus (EBV) infection complicated by acute disseminated encephalomyelitis (ADEM) in a toddler is rare. Our patient is a 14 month-old boy who presented with listlessness and reduced eye movements nearly 10 days after a prodromal upper respiratory illness that was accompanied by an amoxicillin rash. On examination, the boy appeared drowsy, had a congested throat and a resolving lower extremity rash, but otherwise had a normal neurological examination. Investigation revealed lymphocytosis, mildly elevated liver enzyme and a positive EBV IgM serology. Cerebrospinal fluid analysis showed pleocytosis. Subsequent brain and spine MRI showed demyelinating disease extending from the cerebral peduncles, across the brain stem and down to the mid-thoracic spinal cord. The patient was treated as a case of ADEM and given intravenous methylprednisolone. On outpatient follow-up his symptoms resolved completely in 6 weeks.
幼儿期有症状的爱泼斯坦-巴尔病毒（EBV）感染并发急性播散性脑脊髓炎（ADEM）很罕见。我们的患者是一名14个月大的男孩，在出现前驱上呼吸道疾病并伴有阿莫西林皮疹近10天后，出现精神萎靡和眼球活动减少。检查时，该男孩显得嗜睡，喉咙充血，下肢皮疹正在消退，但其他方面神经系统检查正常。检查发现淋巴细胞增多、肝酶轻度升高以及EBV IgM血清学阳性。脑脊液分析显示细胞增多。随后的脑部和脊柱MRI显示脱髓鞘疾病从脑桥延伸至脑干并向下至胸中段脊髓。该患者被作为ADEM病例进行治疗，并给予静脉注射甲基泼尼松龙。门诊随访时，他的症状在6周内完全缓解。
