University of the Incarnate Word School of Osteopathic Medicine, Texas Institute of Graduate Medical Education and Research at Laredo Medical Center, Laredo, US.
University of the Incarnate Word School of Osteopathic Medicine, Texas Institute of Graduate Medical Education and Research at Laredo Medical Center, Laredo, US.
Int J Infect Dis. 2022 Sep;122:976-978. doi: 10.1016/j.ijid.2022.07.046. Epub 2022 Jul 22.
A 60-year-old Hispanic female was admitted with recurrent fevers, altered mental status, lymphadenopathy, hepatosplenomegaly, and pancytopenia. Initially, sepsis was presumed because of recurrent urinary tract infection with extended-spectrum beta-lactamase Escherichia coli. Despite appropriate therapy, her clinical condition continued to decline. An extensive workup was obtained to determine the source of her ailments. Bone marrow biopsy was negative for leukemia, lymphoma, and myelodysplastic syndrome; fluorescence in situ hybridization and a cytogenetic panel were normal; a lumbar puncture was negative. However, peripheral blood was remarkable for elevated titers for Epstein-Barr virus (EBV) consistent with chronic active EBV. Treatment with valganciclovir showed early positive results, but the patient became co-infected with COVID-19, and her EBV titer increased again, resulting in a precipitous health decline and death.
一位 60 岁的西班牙裔女性因反复发热、精神状态改变、淋巴结病、肝脾肿大和全血细胞减少症入院。最初，由于反复尿路感染合并产超广谱β-内酰胺酶的大肠杆菌，考虑为脓毒症。尽管进行了适当的治疗，但她的临床状况仍持续恶化。进行了广泛的检查以确定她疾病的来源。骨髓活检未见白血病、淋巴瘤和骨髓增生异常综合征；荧光原位杂交和细胞遗传学检查均正常；腰椎穿刺也未见异常。然而，外周血中 EB 病毒 (EBV) 的滴度升高，符合慢性活动性 EBV。给予缬更昔洛韦治疗后早期结果阳性，但患者同时感染了 COVID-19，EBV 滴度再次升高，导致健康状况急剧恶化并死亡。
