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- Title
Proven Epstein- Barr encephalitis with negative EBV- DNA load in cerebrospinal fluid after allogeneic hematopoietic stem cell transplantation in a child with acute lymphoblastic leukemia.
- Authors
Barberi, Walter; Perrone, Salvatore; Iori, Anna Paola; Torelli, Giovanni Fernando; Testi, Anna Maria; Moleti, Maria Luisa; Ceglie, Teresa; Papoff, Paola; Caresta, Elena; Antonelli, Manila; Gianno, Francesca; Melone, Antonio; Badiali, Manuela; Giangaspero, Felice; Foà, Robin; Gentile, Giuseppe
- Abstract
We report a case of EBV encephalitis in a seven-yr-old child with Ph+ ALL. Two months after an allogeneic HSCT from his HLA mismatched mother, the patient showed an altered sensorium, generalized seizures, and a left hemiparesis. Brain MRI demonstrated multiple lesions highly suggestive for viral encephalitis. Blood and CSF PCR analyses were negative for the most common viruses involved in immunocompromised patients including EBV. A cerebral biopsy was performed, which showed intense gliosis and perivascular lymphocytic cuffing. PCR analysis performed on brain tissue was positive only for the EBV genome, while extensive investigations for other viral infections were negative. The patient's neurological symptoms rapidly worsened and he died two months later. This case report suggests that in patients presenting neurological and radiological signs of encephalitis after an HSCT, an EBV involvement should be considered, even in the absence of CSF and blood PCR virus detection.
- Subjects
ENCEPHALITIS; EPSTEIN-Barr virus diseases; CEREBROSPINAL fluid; HEMATOPOIETIC stem cell transplantation; LYMPHOBLASTIC leukemia in children; DNA; MAGNETIC resonance imaging of the brain; POLYMERASE chain reaction
- Publication
Pediatric Transplantation, 2015, Vol 19, Issue 1, pE19
- ISSN
1397-3142
- Publication type
Article
- DOI
10.1111/petr.12386