scholarly journals Clinical features and outcomes of brucellosis complicated with Epstein-Barr virus infection

2019 ◽  
Author(s):  
Hai Jiang ◽  
Chaoxia Sun ◽  
Hongyan Zhao ◽  
Xiuying Ni ◽  
Li Zhao ◽  
...  

Abstract Objective To analyze the clinical, laboratory characteristics and prognosis of brucellosis patients with co-existing Epstein-Barr virus (EBV) infection at a major hospital in Shandong, a brucellosis epidemic region of China.Methods A total of 576 inpatients diagnosed with brucellosis at Yidu Central Hospital, between July 2013 and July 2018, were selected and tested for EBV DNA. 22 patients were found to be positive for co-infection with EBV. The clinical data of these 22 patients (observation group) and 100 patients (control group) with only brucellosis were retrospectively compared.Results The observation group (the group with the EBV co-infection) had more severe clinical manifestations in the form of fever, headache, and hepatosplenomegaly. Further, the observation group also had a significantly higher number of patients with elevated alanine transaminase(ALT) and aspartate-aminotransferase (AST), reduced WBC, and elevated PLT count. The incidence of abnormal levels of cardiac enzyme was also significantly higher in the observation group, as was the recovery time and average hospitalization period.Conclusions It is important to consider EBV infection and other potentially latent viral infections in patients with brucellosis, as these infections can further complicate the disease course. Further, patients diagnosed with a co-infection should be administered combined antibacterial and antiviral treatment and kept under observation and followed up for a longer period.

2020 ◽  
Vol 70 (5) ◽  
pp. 312-322
Author(s):  
Andrea J Osborne ◽  
Hannah M Atkins ◽  
Karla K Balogh ◽  
Sarah A Brendle ◽  
Debra A Shearer ◽  
...  

Epstein-Barr Virus (EBV) is a γ-herpesvirus which infects over 90% of the adult human population. Most notably, this virus causes infectious mononucleosis but it is also associated with cancers such as Hodgkin and Burkitt lymphoma. EBV is a species-specific virus and has been studied in many animal models, including nonhuman primates, guinea pigs, humanized mice, and tree shrews. However, none of these animal models are considered the "gold standard" for EBV research. Recently, rabbits have emerged as a viable alternative model, as they are susceptible to EBV infection. In addition, the EBV infection progresses after immune suppression with cyclosporine A (CsA), modeling the reactivation of EBV after latency. We sought to refine this model for acute or active EBV infections by performing antibody-mediated depletion of certain immune subsets in rabbits. Fourteen 16 to 20-wk old, NZW rabbits were intravenously inoculated with EBV and concurrently treated with either anti-CD4 T-cell antibody, anti-pan-T-cell antibody (anti CD45), CSA, or, as a control, anti-HPV antibody. Rabbits that received the depleting antibodies were treated with CsA 3 times at a dose of 15 mg/kg SC once per day for 4 d starting at the time of EBV inoculation then the dose was increased to 20 mg/kg SC twice weekly for 2 wk. Weights, temperatures, and clinical signs were monitored, and rabbits were anesthetized once weekly for blood collection. When compared with the control group, anti-CD4-treated rabbits had fewer clinical signs and displayed higher levels of viral DNA via qPCR in splenocytes; however, flow cytometry results showed only a partial depletion of CD4 T-cells. Treatment with anti-pan-T-cell antibody did not result in noticeable T-cell depletion. These data suggest the EBV-infected rabbit is a promising model for testing antiviral medications and prophylactic vaccines for EBV.


2021 ◽  
Vol 100 (1) ◽  
pp. 36-41
Author(s):  
Tatiana V. Solomay ◽  
Tatiana A. Semenenko

To systematize the existing methods, techniques, and means of non-specific prevention transmission of the Epstein-Barr virus (EBV) in medical institutions, the authors perform a comprehensive analysis of data from domestic and foreign literature. Information was collected using Scopus, Web of Science, MedLine, the Cochrane Library, PubMed, RSCI, Cyberleninka. The analysis revealed data confirming the relevance of EBV infection for different areas of clinical medicine. Researchers do not classify EBV as a causative agent of diseases associated with medical care. Measures aimed at preventing transmission of EBV infection similar to those of other illnesses should consider the existing mechanisms of the transmission and the pathogen’s characteristics. The lifetime persistence of EBV in the human body, the presence of the pathogen in various organs and tissues during the active infection, the polymorphism of clinical manifestations of the disease, along with errors in compliance with disinfection and sterilization regimes, create a risk of cross-infection in medical institutions of various profiles. Intensive introduction into medical practice of modern including invasive methods of diagnosis and treatment assisted reproductive technologies; medical equipment contributes to the emergence of new factors of transmission of EBV infection and requires the development of standard protocols for their disinfection and sterilization. To improve medical staff’s competence it is necessary to introduce more widely training activities on preventive and anti-epidemic measures in the system of continuing medical education.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Aisha Yassin Abdul-Ghaffar ◽  
Dalia Youssef Samaha ◽  
Nancy Samir Wahba ◽  
Ahmed Essam Ali Hussein

Abstract Background Multiple sclerosis (MS) is an immune mediated inflammatory disease that attacks myelinated axons in the central nervous system (CNS), destroying the myelin and the axon in variable degrees. The aetiology and pathogenesis of MS is complex and multifactorial, involving many interlacing mechanisms. Many theories had considered viral infections as a possible cause of MS. One of these viruses is Epstein-Barr virus (EBV), a herpes virus belonging to the family herpesviridae. There is obvious similarity between EBV and MS regarding their epidemiological pictures, and it was observed that most MS patients had a history of infectious mononucleosis (IM) a few years before onset. The relation between EBV and MS may give hope for development of biomarkers for prediction of disease development, early diagnosis, prediction of prognosis, curing or even preventing MS through an anti EBV vaccine or antiviral therapies. Objectives This study aims to analyze the association between EBV infection and multiple sclerosis. Subjects and Methods This is a case control study carried in the MS outpatient clinic at Ain Shams University Hospitals during the period from April 2019 till November 2019. Subjects included in this study were classified into two groups. The first group included 30 patients diagnosed as having MS, on the basis of their MRI finding, clinical presentation and according to revised Mc Donald criteria 2017. The patient group included 11 males and 19 females, their age ranged from 18 to 48 years. The second group included 30 age and sex matched healthy controls without any neurological or medical diseases. The control group included 11 males and 19 females, their age ranged from 18 to 48 years. Both groups were tested quantitatively for immunoglobulin G against Epstein Barr viral capsid antigen (VCA) using the enzyme linked immunosorbent assay technique (ELISA). Results All patients with MS (100%) were positive for EBV VCA IgG, whereas (93.33%) of controls were positive. In the MS group, the EBV VCA IgG mean level was (161± 66.32) U/ml compared with (78.53±47.63) U/ml in controls. The difference in serum level of EBV VCA IgG between both groups was statistically highly significant (P = < 0.001). Conclusion There were higher levels of EBV VCA IgG in the serum of MS patients compared to healthy controls. This finding postulates a relation between EBV infection and MS and its role in the pathogenesis of MS.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Zuhal Yesilbag ◽  
Asli Karadeniz ◽  
Fatih Oner Kaya

Primary Epstein-Barr virus (EBV) infection is almost always a self-limited disease characterized by sore throat, fever, and lymphadenopathy. Hepatic involvement is usually characterized by mild elevations of aminotransferases and resolves spontaneously. Although isolated gallbladder wall thickness has been reported in these patients, acute acalculous cholecystitis is an atypical presentation of primary EBV infection. We presented a young women admitted with a 10-day history of fever, nausea, malaise who had jaundice and right upper quadrant tenderness on the physical examination. Based on diagnostic laboratory tests and abdominal ultrasonographic findings, cholestasis and acute acalculous cholecystitis were diagnosed. Serology performed for EBV revealed the acute EBV infection. Symptoms and clinical course gradually improved with the conservative therapy, and at the 1-month follow-up laboratory findings were normal. We reviewed 16 adult cases with EBV-associated AAC in the literature. Classic symptoms of EBV infection were not predominant and all cases experienced gastrointestinal symptoms. Only one patient underwent surgery and all other patients recovered with conservative therapy. The development of AAC should be kept in mind in patients with cholestatic hepatitis due to EBV infection to avoid unnecessary surgical therapy and overuse of antibiotics.


Author(s):  
O. Abrahamovych ◽  
U. Abrahamovych ◽  
S. Guta ◽  
M. Farmaha ◽  
L. Kobak

Introduction. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by various manifestations and clinical course, many aspects of the etiology and pathogenesis of which remain unclear. Recently, the interest of researchers in studying the role of cytomegalovirus (CMV) and Epstein - Barr virus (EBV) has been growing in the occurrence and course of a number of human diseases due to their ability to affect almost all organs and systems of the body, causing the formation of latent, active or chronic infection, which can often cause temporary disability, disability or even death, however, for the patients with SLE, despite the possibility of approaching the difficult problem of diagnosis and treatment of this disease, this issue is given insufficient attention, as evidenced by isolated studies.The aim of the study. Detect cytomegalovirus and Epstein - Barr infection in patients with systemic lupus erythematosus and its dependence on gender and age of patients. Materials and methods of research. The study involved 120 patients (15 men (12.50%) and 105 women (87.50%) aged 18 to 69 years with SLE, who were in the rheumatology department of the Communal Non-Commercial Enterprise of the Lviv Regional Council "Lviv Regional Clinical Hospital" in 2014-2019. To diagnose CMV and EBV infection by enzyme-linked immunosorbent assay, antibodies of IgM and IgG to viruses were detected in blood serum, and viruses were detected by polymerase chain reaction. According to the results of virus detection, formed groups of the patients, namely: patients with active CMV infection, active EBV, active CMV and EBV, without active CMV and EBV. All patients with SLE included in the study were subsequently stratified by age according to the classification of the World Health Organization (2015), according to which the following age limits were determined: young age, middle-aged, elderly, senile. Statistical analysis was performed on a personal computer in MS Excel and Statistica 6.0 using descriptive statistics. The frequency of cases of active CMV and EBV infection was calculated mathematically by the binomial coefficient of I. Newton. Research results and their discussion. We found in the vast majority of patients with SLE (117 patients, 97.50%) increase in the titer of specific antibodies to CMV. Only in 3 patients (2.50%) the titer of antibodies to this virus was within normal limits. Analyzing the frequency of EBV infection in patients with SLE, we recorded an increase in the titer of specific antibodies to the virus in 119 patients (99.17%). Among the examined patients with SLE in all (100.00%) found an increase in the titer of antibodies to CMV and / or EBV, of which 97.50% - infected with CMV and 97.17% - infected with EBV. The active phase of CMV and / or EBV infection was detected in 54.17%, of which 23.33% - active CMV infection, 17.50% - active EBV infection and 12.50% - a combination of active CMV and EBV infection simultaneously, which indicates a high frequency of CMV and EBV infection in patients with SLE and reflects the urgency of the problem of diagnosing herpesvirus infection in them. We found that activeCMV, EBV infections and their combinations are present only in women (64 patients, which is 60.96% of the total number of women with SLE), of which 28 patients (26.67%) there was only active CMV infection, in 21 patients (20.00%) - only active EBV infection and in 15 patients (14.29%) – combination of active CMV and EBV infection. 41 women (39.05%) and all (100.00%) men were not found to have active CMV and EBV infection, which indicates that men at the time of the survey were significantly more likely to have this infection in the integration phase. The most frequently active EBV infection was detected in patients with SLE of young age (17 cases, 24.64%), and in middle-aged patients 3 cases (6.52%) were recorded, which indicates a significant (p <0.05) difference in the frequency of cases of active EBV infection in patients of both groups. Only 1 case (20.00%) of active EBV infection was detected in elderly patients. Conclusions. All patients with systemic lupus erythematosus are infected - 97.50% with cytomegalovirus and 97.17% with Epstein-Barr virus infection, that was confirmed by the increased titer of antibodies to them. Among the mentioned patients 53.33% of them had the active phase of infection (23.33% - cytomegalovirus infection in the replication phase, 17.50% - the Epstein- Barr virus infection in the replication phase and 12.50% - their combination). The prevalence of active viral infection in patients with systemic lupus erythematosus depends on gender (active cytomegalovirus, active Epstein-Barr virus infection and their combination are significantly more common in women) and age - they are probably more common in young patients.  


2020 ◽  
Author(s):  
Jinjin Shi ◽  
Chu Chu ◽  
Min Yu ◽  
Dandan Zhang ◽  
Yuqin Li ◽  
...  

Abstract Objectives This study aimed to compare the clinical features and laboratory tests of infectious mononucleosis (IM) and hemophagocytic syndrome (HLH) caused by Epstein-Barr virus (EBV) in 1-3-year-old children and to explore the risk factor of HLH caused by EBV (EBV-HLH). Methods The clinical data of 92 children with EBV infection admitted in our hospital from 2011 to 2019 were collected; 61 cases were diagnosed as EBV-IM, and 31 cases were diagnosed as EBV-HLH. The subjects’ clinical manifestations and laboratory tests were analyzed retrospectively. Results Compared with EBV-IM patients, EBV-HLH patients had longer durations of fever, both before hospitalization and overall, and a higher probability of hepatomegaly. The levels of ALT, AST, LDH, TG, SF, D-Dimer and the plasma EBV DNA load of EBV-HLH patients were significantly higher than those of EBV-IM patients. The absolute values of CD3+, CD4+, CD8+, NK, and CD3-CD19+ cells and IgA and IgM levels of EBV-HLH patients were significantly lower than those of EBV-IM patients. The plasma EBV DNA load was positively correlated with the PT, TT, α-HBDH, AST, LDH, CK, Scr, BUN, UA, TG, and CRP levels in EBV-HLH patients, and the plasma EBV DNA load was positively correlated with the D-Dimer level in the EBV-IM patients. Among the 10 different potential markers, at the cut-off point of 1721.500 µg/L, the sensitivity and specificity of D-Dimer was 88.90% and 90.20%, respectively. Conclusion The D-Dimer level may be a good prognostic indicator of EBV-HLH caused by EBV.


2021 ◽  
pp. 549-554
Author(s):  
Berrin Pelit Uzunalimoğlu ◽  
Abdülhamit Sağlam ◽  
Büşra Şişman ◽  
Sefer Günaydın ◽  
Esen Gül Uzuner ◽  
...  

Epstein-Barr virus (EBV) has been associated with a plethora of neurological manifestations including polyneuropathy and polyradiculopathy. A 27-year-old man with a recent upper respiratory system infection presented with difficulty in walking. His neurological examination revealed reduced muscle strength in both proximal and distal lower limb muscles without sensory and autonomic signs. Needle electromyography showed abnormal spontaneous activity and reduced recruitment of motor units in muscles innervated by multiple lumbo-sacral roots. Cerebrospinal examination showed increased protein levels with normal cell counts. While spinal MRI was normal, whole-body CT and PET examination showed disseminated lymph node enlargement. Anti-EBV viral capsid antigen and anti-nuclear antigen IgG but not IgM was positive, whereas EBV PCR was negative in blood. Analysis of inguinal lymph node biopsy showed reactive lymphoid hyperplasia and EBV DNA. Leucine-rich glioma-inactivated protein 1 (LGI1) antibody was found in serum but not in CSF. All clinical, imaging, and electrophysiological findings improved following steroid and intravenous immunoglobulin treatment. These findings suggested the acute involvement of lumbo-sacral spinal roots and/or motor neurons. Purely motor polyradiculopathy has been reported in both EBV-positive and LGI1 antibody-positive patients, and EBV infection is known to precede different autoimmune manifestations. Whether EBV infection may trigger LGI1 autoimmunity and cause involvement of spinal motor roots and/or motor neurons needs to be further studied.


PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 964-967
Author(s):  
THOMAS J. BOWEN ◽  
RALPH J. WEDGWOOD ◽  
HANS D. OCHS ◽  
WERNER HENLE

In vivo and in vitro humoral and cellular immune responses were studied in a 2½-year-old girl immediately before, during, and after an asymptomatic infection with Epstein-Barr virus. During the acute EBV infection, the patient's peripheral blood mononuclear cells were deficient in immunoglobulin synthesis and suppressed the in vitro immunoglobulin synthesis of normal allogeneic cells. In vitro mitogen transformation of lymphocytes was reduced. In vivo antibody responses to the T cell-dependent antigens bacteriophage φX 174 and Keyhole limpet hemocyanin were markedly depressed. These studies suggest that suppressor cells induced during acute EBV infection not only suppress immunoglobulin synthesis in vitro, but also interfere with in vivo antibody synthesis.


Blood ◽  
1991 ◽  
Vol 77 (5) ◽  
pp. 1092-1095 ◽  
Author(s):  
A Neri ◽  
F Barriga ◽  
G Inghirami ◽  
DM Knowles ◽  
J Neequaye ◽  
...  

Abstract The Epstein-Barr virus (EBV) is associated with distinct forms of human lymphoid malignancies, including the endemic (eBL) and sporadic forms of Burkitt's lymphoma (sBL) and acquired immunodeficiency syndrome- associated non-Hodgkin lymphoma (AIDS-NHL). However, whether EBV has a pathogenetic role in these tumors or is a passenger virus has not been conclusively demonstrated. One element to distinguish between these two possibilities is to determine whether EBV infection has preceded and, thus, possibly contributed to clonal expansion, or whether infection has occurred after clonal expansion and thus is unlikely to contribute to pathogenesis. Toward this end we analyzed the structure of the heterogeneous genomic termini of EBV as markers of clonal infection in a panel of eBL (11 cases), sBL (9 cases), and AIDS-NHL (10 cases) biopsies. We show that EBV termini are uniformly clonal in sBL, eBL, and AIDS-NHL, strongly suggesting that EBV infection has preceded and, thus, most likely contributed to clonal expansion in these malignancies.


Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2722
Author(s):  
Fenggang Yu ◽  
Yanan Lu ◽  
Yingying Li ◽  
Yuji Uchio ◽  
Utomo Andi Pangnguriseng ◽  
...  

Epstein–Barr virus (EBV) is a human oncogenic virus that causes several types of tumor, such as Burkitt’s lymphoma and nasopharyngeal carcinoma (NPC). NPC tumor cells are clonal expansions of latently EBV-infected epithelial cells. However, the mechanisms by which EBV transforms the nasopharyngeal epithelium is hampered, because of the lack of good in vitro model to pursue oncogenic process. Our primary nasopharyngeal epithelial cell cultures developed pseudostratified epithelium at the air-liquid interface, which was susceptible to EBV infection. Using the highly sensitive RNA in situ hybridization technique, we detected viral infection in diverse cell types, including ciliated cells, goblet cells, and basal cells. EBV-encoded small RNA-positive cells were more frequently detected in the suprabasal layer than in the basal layer. We established the most physiologically relevant EBV infection model of nasopharyngeal epithelial cells. This model will advance our understanding of EBV pathogenesis in the development of NPC.


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