Epstein-Barr virus encephalitis in a renal transplant recipient manifesting as hemorrhagic, ring-enhancing mass lesions

Transpl Infect Dis. 2015 Oct;17(5):744-50. doi: 10.1111/tid.12431. Epub 2015 Sep 26.

Abstract

Epstein-Barr virus (EBV) encephalitis has been infrequently described in immunocompromised patients. Here, we report a unique case of biopsy-proven EBV encephalitis in a renal transplant recipient presenting with altered mental status, prominent visual disturbances, and hemorrhagic, ring-enhancing mass lesions on magnetic resonance imaging. The patient was successfully treated with a prolonged course of antivirals. This case illustrates the difficulty in interpretation of cerebrospinal fluid EBV polymerase chain reaction assay, given the lack of specificity in immunocompromised patients.

Keywords: Epstein-Barr virus; encephalitis; ganciclovir; immunocompromise; post-transplant lymphoproliferative disorder; primary central nervous system lymphoma; renal transplant; valganciclovir.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Encephalitis / diagnosis*
  • Encephalitis / etiology
  • Encephalitis / immunology
  • Epstein-Barr Virus Infections / diagnosis*
  • Epstein-Barr Virus Infections / etiology
  • Epstein-Barr Virus Infections / immunology
  • Humans
  • Immunocompromised Host*
  • Intracranial Hemorrhages / diagnosis
  • Intracranial Hemorrhages / etiology*
  • Kidney Transplantation*
  • Male
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / immunology