Journal of NeuroVirology

, Volume 22, Issue 5, pp 695–698 | Cite as

Epstein-Barr virus hemorrhagic meningoencephalitis: case report and review of the literature

  • Bianca Branco AscençãoEmail author
  • Ana Catarina Gonçalves
  • Nuno Luís
  • Joana Sá
  • Ana Paula Brito
  • José Manuel Poças
Case Report


Neurologic complications related to Epstein-Barr virus (EBV) in immunocompetent adults are rare and most commonly self-limited. However, severe cases have been previously reported in the literature. We describe a case of meningoencephalitis with frontal bilateral hemorrhage in a non-immunocompromised adult following an EBV infection of the central nervous system confirmed by the presence of EBV-DNA in the cerebrospinal fluid. During the patient’s hospital stay, there was a favorable clinical and radiologic evolution and the patient was discharged asymptomatic. To our knowledge, this is the fourth case of hemorrhagic meningoencephalitis related to EBV and the first one in an immunocompetent patient with a favorable outcome.


Meningoencephalitis EBV Hemorrhage 


Compliance with ethical standards



Conflict of interest

None declared.

Ethical approval

Not required.


  1. Chadha SN, Amrol D (2010) X-linked lymphoproliferative disease presenting as pancytopenia in a 10-month-old boy. Case Rep Med 2010:517178PubMedPubMedCentralGoogle Scholar
  2. Epstein MA, Barr YM, Achong BG (1964) A second virus-carrying tissue culture strain (EB2) of lymphoblasts from Burkitt’s lymphoma. Pathol Biol (Paris) 12:1233–1234Google Scholar
  3. Francisci D, Sensini A, Fratini D, Moretti MV, Luchetta ML, Di Caro A, Stagni G, Baldelli F (2004) Acute fatal necrotizing hemorrhagic encephalitis caused by Epstein-Barr virus in a young adult immunocompetent man. J Neurovirol 10(6):414–417CrossRefPubMedGoogle Scholar
  4. Fujimoto H, Asaoka K, Imaizumi T, Ayabe M, Shoji H, Kaji M (2003) Epstein-Barr vírus infections of the central nervous system. Intern Med 42(1):33–40CrossRefPubMedGoogle Scholar
  5. Häusler M, Ramaekers VT, Doenges M, Schweizer K, Ritter K, Schaade L (2002) Neurological complications of acute and persistent Epstein-Barr virus infection in paediatric patients. J Med Virol 68(2):253–263CrossRefPubMedGoogle Scholar
  6. Henle G, Henle W, Diehl V (1968) Relation of Burkitt’s tumor-associated herpes-ytpe virus to infectious mononucleosis. Proc Natl Acad Sci U S A 59(1):94–101CrossRefPubMedPubMedCentralGoogle Scholar
  7. Imai S, Usui N, Sugiura M, Osato T, Sato T, Tsutsumi H, Tachi N, Nakata S, Yamanaka T, Chiba S et al (1993) Epstein-Barr virus genomic sequences and specific antibodies in cerebrospinal fluid in children with neurologic complications of acute and reactivated EBV infections. J Med Virol 40(4):278–284CrossRefPubMedGoogle Scholar
  8. Ito H, Sayama S, Irie S, Kanazawa N, Saito T, Kowa H, Haga S, Ikeda K (1994) Antineuronal antibodies in acute cerebellar ataxia following Epstein-Barr vírus infection. Neurology 44(8):1506–1507CrossRefPubMedGoogle Scholar
  9. Mizutani T, Murashima A, Shiozawa R, Kamei S (1993) Unusual neurologic manifestations associated with Epstein-Barr virus infection. Intern Med 32(1):36–38CrossRefPubMedGoogle Scholar
  10. Patil AK, Azad ZR, Mathew V, Alexander M (2012) Chronic meningitis and central nervous system vasculopathy related to Epstein Barr virus. Ann Indian Acad Neurol 15(4):303–306CrossRefPubMedPubMedCentralGoogle Scholar
  11. Sabat S, Agarwal A, Zacharia T, Labid S, Yousef J (2015) Epstein-Barr virus encephalitis presenting as cerebellar hemorrhage. Neuroradiol J 28(6):555–558CrossRefPubMedGoogle Scholar
  12. Takeuchi S, Takasato Y, Masaoka H, Hayakawa T, Otani N, Yoshino Y, Yatsushige H, Sugawara T (2010) Hemorrhagic encephalitis associated with Epstein-Barr virus infection. J Clin Neurosci 17(1):153–154CrossRefPubMedGoogle Scholar
  13. Todman DH (1983) Encephalitis in infectious mononucleosis. Clin Exp Neurol 19:81–86PubMedGoogle Scholar

Copyright information

© Journal of NeuroVirology, Inc. 2016

Authors and Affiliations

  • Bianca Branco Ascenção
    • 1
    Email author
  • Ana Catarina Gonçalves
    • 1
  • Nuno Luís
    • 1
  • Joana Sá
    • 1
  • Ana Paula Brito
    • 1
  • José Manuel Poças
    • 1
  1. 1.Centro Hospitalar de SetúbalSetubalPortugal

Personalised recommendations