%0 Journal Article
%T Clinical characteristics of patients with Epstein Barr virus in cerebrospinal fluid
%A Timi Martelius
%A Maija Lappalainen
%A Maarit Palom£¿ki
%A Veli-Jukka Anttila
%J BMC Infectious Diseases
%D 2011
%I BioMed Central
%R 10.1186/1471-2334-11-281
%X We reviewed the medical records, imaging and laboratory findings of all patients EBV DNA PCR positive in cerebrospinal fluid (CSF) during 2000 to 2009 in the Helsinki University Central Hospital.We identified 32 patients with EBV DNA in CSF. 11 had history of allogeneic hematopoietic stem cell transplantation, 7 solid organ transplantation and 5 HIV/AIDS. 5 patients had no preceding immunodeficiency.In 8 of the cases, another pathogen was identified in CSF. These were M. tuberculosis (2), T. gondii (2), Aspergillus (1), Herpes simplex virus 1 (1), C. neoformans (1) and Human herpesvirus 6 (1). Altogether in 15/32 (47%) of the cases the clinician had a strong suspicion of cause other than EBV for the patients' CNS symptoms/findings.Of note, 7 of 11 (64%) patients with stem cell transplantation had encephalitis (univariate odds ratio 5.6; confidence Interval 1.1-27.4). Of these 6 had no other pathogen identified.EBV DNA was often found together with other microbial findings in CSF of immunocompromised patients. EBV seems to be associated with encephalitis in stem cell transplant recipients.Epstein-Barr virus infects over 90% of the world population and is the causative agent of infectious mononucleosis. Reactivation of latent EBV is clinically significant in immunocompromised patients and as a rule accompanies lymphoproliferative disease [1].Central nervous system (CNS) complications of Epstein-Barr virus (EBV) infection occur in 1 to 18% of patients with infectious mononucleosis and include encephalitis, meningitis, cerebellitis, polyradiculomyelitis, transverse myelitis, cranial and peripheral neuropathies, and psychiatric abnormalities [2-4]. EBV is associated with CNS lymphoma and encephalitis, and EBV viral load in CSF is higher than in postinfectious complications [4]. However, this study had a highly selected patient material, e.g. 50% had central nervous system lymphoma.On the other hand EBV-DNA was commonly detected in CSF of HIV patients with other CNS infec
%U http://www.biomedcentral.com/1471-2334/11/281