Fackler J C, Nagel J E, Adler W H, Mildvan P T, Ambinder R F
Am J Dis Child. 1985 Oct;139(10):1000-4. doi: 10.1001/archpedi.1985.02140120046026.
A 3-year-old girl, born to an intravenous-drug-dependent mother, had protracted diarrhea, failure to thrive, generalized lymphadenopathy, and recurrent fevers during the first six months of life. At 7 months of age, the Epstein-Barr virus (EBV) genome was detected in her saliva by DNA dot-blot hybridization using a cloned EBV probe. Spontaneous EBV+ lymphoblastoid cell lines had repeatedly developed from her peripheral blood lymphocytes over the subsequent 2 1/2 years. At 11 months of age, persistent tachypnea and a diffuse pulmonary infiltrate developed. Lung biopsy demonstrated a florid, peribronchiolar lymphocytic infiltrate and the EBV genome was identified in the lung tissue. Serum anti-EBV antibodies remained undetectable until 14 months of age. She had a T4+/T8+ ratio of less than 0.8 and serum antibody to human T-cell lymphotropic virus type III. The delayed seroresponse of this patient to symptomatic EBV infection suggests that reliance on EBV serology to diagnose EBV infection in immunocompromised hosts may be inappropriate, and other methods such as DNA probes should be used.
一名3岁女孩，其母亲为静脉药物依赖者，在出生后的头6个月出现了迁延性腹泻、生长发育迟缓、全身淋巴结肿大及反复发热。7个月大时，使用克隆的EB病毒探针通过DNA斑点杂交在其唾液中检测到EB病毒（EBV）基因组。在随后的2年半时间里，其外周血淋巴细胞反复自发形成EBV阳性淋巴母细胞系。11个月大时，出现持续的呼吸急促和弥漫性肺部浸润。肺活检显示有明显的支气管周围淋巴细胞浸润，且在肺组织中鉴定出EBV基因组。血清抗EBV抗体直到14个月大时仍未检测到。她的T4+/T8+比值小于0.8，且血清中有人嗜T细胞病毒III型抗体。该患者对有症状的EBV感染的血清反应延迟表明，在免疫功能低下的宿主中依靠EBV血清学来诊断EBV感染可能不合适，应使用DNA探针等其他方法。
