N. Nosaka et al. / Open Journal of Pediatrics 1 (2011) 72-74
Copyright © 2011 SciRes. OJPed
74
the context of severe illness.
To our knowledge, this report is the first to describe a
patient with AESD associated with EBV infection. EBV
is one of the most common identifiable causes of acute
childhood encephalitis; EBV has been detected in the
central nervous system of 10% of children with acute
encephalitis [7,8]. Neurologic complications of EBV
infection are diverse and include encephalitis, cerebelli-
tis, aseptic meningitis, transverse myelitis, Guillain-
Barre syndrome, cranial neuritis and others [8,9]. EBV
encephalitis does not occur in the majority of patients
presenting with infectious mononucleosis [9]. MRI has a
low specificity for EBV encephalitis [10]. The prognosis
associated with EBV encephalitis is controversial and
ranges in severity from mild to fatal [8,9]. These features
were consistent with the present case with the exception
of the biphasic clinical course. Because the classic labo-
ratory hallmarks of infectious mononucleosis—for ex-
ample, typical lymphocytosis—are absent and early di-
agnosis of EBV infection is sometimes difficult, EBV
may be not recognized as a pathogen in cases of AESD.
A combination serologic and PCR assay will allow de-
tection of any association of EBV with AESD.
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