Kasimo Betty A, Yahaya James J, Yoon Sun Och, Kim Se Hoon, Jung Minsun
Department of Pathology, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
Department of Pathology, School of Health Sciences, Soroti University, Soroti, Uganda.
J Pathol Transl Med. 2025 May;59(3):188-194. doi: 10.4132/jptm.2025.02.21. Epub 2025 Apr 16.
Chronic active Epstein-Barr virus (CAEBV) can induce complications in various organs, including the brain and gastrointestinal tract. A 3-year-old boy was referred to the hospital with a history of fever and seizures for 15 days. A diagnosis of encephalitis based on computed tomography (CT) and magnetic resonance imaging findings and clinical correlation was made. Laboratory tests showed positive serology for Epstein-Barr virus (EBV) and negative for Rotavirus antigen and IgG and IgM antibodies for cytomegalovirus, herpes simplex virus, and varicella zoster virus, respectively. Abdominal CT showed diffuse wall thickening with fluid distension of small bowel loops, lower abdomen wall thickening, and a small amount of ascites. The biopsy demonstrated positive Epstein-Barr encoding region in situ hybridization in cells within the crypts and lamina propria. The patient was managed with steroids and hematopoietic stem cell transplantation (HSCT). This case showed histopathological characteristics of concurrent EBV-associated encephalitis and colitis in CAEBV infection. The three-step strategy of immunosuppressive therapy, chemotherapy, and allogeneic HSCT should be always be considered for prevention of disease progression.
慢性活动性EB病毒（CAEBV）可在包括脑和胃肠道在内的多个器官引发并发症。一名3岁男孩因发热和惊厥病史15天被转诊至医院。根据计算机断层扫描（CT）和磁共振成像结果以及临床相关性诊断为脑炎。实验室检查显示EB病毒（EBV）血清学呈阳性，轮状病毒抗原以及巨细胞病毒、单纯疱疹病毒和水痘带状疱疹病毒的IgG和IgM抗体均为阴性。腹部CT显示小肠袢壁弥漫性增厚伴肠腔积液扩张、下腹部壁增厚以及少量腹水。活检显示隐窝和固有层内细胞的EB病毒编码区原位杂交呈阳性。该患者接受了类固醇和造血干细胞移植（HSCT）治疗。此病例显示了CAEBV感染中并发EBV相关性脑炎和结肠炎的组织病理学特征。为预防疾病进展，应始终考虑采用免疫抑制治疗、化疗和异基因HSCT的三步策略。
