A Case of Encephalitis Caused by Epstein-Barr Virus Infection

발열을 동반한 경련 이후 의식 저하를 주소로 내원한 환아에서 전형적인 전염성 단핵구증의 증상 및 비정형 림프구 혈증, 혈청학적 검사에서 양성 소견을 보여 EBV 감염에 의한 전염성 단핵구증의 합병증으로 발생한 뇌염으로 진단한 증례가 있어 보고하는 바이다.

An 11-year-old girl was diagnosed with encephalitis due to Epstein-Barr virus(EBV). She was admitted to our hospital due to convulsion and decreased consciousness after several days of fever, sore throat and headache. Cerebrospinal fluid analysis showed lymphocyte-dominant pleocytosis and markedly elevated levels of protein. Magnetic resonance imaging(MRI) finding was normal, except for marked leptomeningeal enhancement. Even though she had signs and symptoms of infectious mononucleosis, EBV infection could not be considered as the underlying cause of the encephalitis until IgM for the viral capsid antigen of EBV had been detected in her blood. After treatment with acyclovir, a high dose of methylprednisolone and intravenous immunoglobulin, the neurological symptoms improved rapidly. She has not suffered from any neurological complications in the four months since being discharged. EBV infection should be considered as the main etiology in cases of childhood encephalitis, although there is no evidence of infectious mononucleosis existed.