Maurício Kátia, Beir Joana De, Alvelos Rita, Sobreira Inês, Santos Joana
Department of Paediatrics, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
Department of Paediatrics, Hospital Pediátrico, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Case Rep Pediatr. 2025 Jun 13;2025:7278571. doi: 10.1155/crpe/7278571. eCollection 2025.
Primary infection by the Epstein-Barr virus (EBV) is common in children, can affect multiple organs and be associated with a wide variety of clinical manifestations. We present the case of a 7-year-old female patient assessed in the emergency department for bitemporal swelling with a one-day evolution, following self-limiting odynophagia and fever 1 week earlier. Physical examination revealed a soft, bitemporal swelling, more evident on the right, painful on palpation, with no other inflammatory signs. The soft tissue ultrasound showed no alterations, and the CT scan showed thickening of the right parietotemporal epicranial soft tissues, of an imprecise nature. At a 2-week follow-up consultation, swelling had completely resolved. The serological study revealed previous contact with cytomegalovirus and positive EBV IgG and IgM with negative EBNA IgG and EA IgG, indicative of acute EBV infection. Bitemporal oedema is a very atypical and rare presentation of primary EBV infection, with very few cases previously reported. The aim of this clinical case is to draw attention to the importance of considering EBV infection in the differential diagnosis of situations like the one described.
爱泼斯坦-巴尔病毒（EBV）的原发性感染在儿童中很常见，可累及多个器官，并伴有多种临床表现。我们报告一例7岁女性患者，1周前出现自限性咽痛和发热，1天后因双侧颞部肿胀在急诊科就诊。体格检查发现双侧颞部有柔软的肿胀，右侧更明显，触诊时有压痛，无其他炎症体征。软组织超声检查未见异常，CT扫描显示右侧顶颞部头皮软组织增厚，性质不明确。在2周后的随访会诊中，肿胀已完全消退。血清学研究显示既往曾接触巨细胞病毒，EBV IgG和IgM阳性，EBNA IgG和EA IgG阴性，提示急性EBV感染。双侧颞部水肿是原发性EBV感染一种非常不典型且罕见的表现，此前报道的病例很少。本临床病例的目的是提醒人们在鉴别诊断此类情况时考虑EBV感染的重要性。
