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Unusual association of diseases/symptoms
CASE REPORT
Primary Epstein-Barr virus infection in immunocompetent patients with acute transverse myelitis and a combination of polyradiculitis and anterior horn syndrome as neurological manifestations
  1. Michiel H F Poorthuis1,
  2. Suzanne Battjes1,
  3. J Wendelien Dorigo-Zetsma2,
  4. Jelle R de Kruijk1
  1. 1Department of Neurology, Tergooi, Blaricum, The Netherlands
  2. 2Department of Medical Microbiology, Tergooi, Blaricum, The Netherlands
  1. Correspondence to Michiel H F Poorthuis, m.h.f.poorthuis{at}gmail.com

Summary

Neurological manifestations of a primary Epstein-Barr virus (EBV) infection are rare. We describe a case with acute transverse myelitis and another case with a combination of polyradiculitis and anterior horn syndrome as manifestations of a primary EBV infection.

The first case is a 50-year-old immunocompetent male diagnosed with acute transverse myelitis, 2 weeks after he was clinically diagnosed with infectious mononucleosis. The second case is an 18-year-old immunocompetent male diagnosed with a combination of polyradiculitis and anterior horn syndrome while he had infectious mononucleosis. The first patient was treated with methylprednisolone. After 1 year, he was able to stop performing clean intermittent self-catheterisation. The second patient completely recovered within 6 weeks without treatment.

Primary EBV infection should be considered in immunocompetent patients presenting with acute transverse myelitis and a combination of polyradiculitis and anterior horn syndrome. Antiviral treatment and steroids are controversial, and the prognosis of neurological sequelae is largely unknown.

  • infection (neurology)
  • spinal cord
  • infectious diseases
  • neurology
  • motor neurone disease

https://doi.org/10.1136/bcr-2018-225333

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    Footnotes

    • Contributors All authors contributed to the conception and design, acquisition of data or analysis and interpretation of data. MHFP wrote the first draft of the manuscript. SB, JWD-Z and JRdK revised the manuscript critically for important intellectual content. All authors approved the final version for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.