A case of severe Epstein-Barr viral hepatitis with the development of hepatic cell failure and encephalopathy in a 1-year old child

Abstract

Objective: The article describes a clinical case of severe Epstein-Barr viral hepatitis in a child aged 1.Materials and methods. The diagnosis of Epstein-Barr mononucleosis was confirmed by repeated isolation of Epstein-Barr virus DNA from the blood by PCR, and IgM to the capsid antigen detection in the blood. Atypical mononuclear cells in blood tests were not detected throughout the disease course.Results. The main clinical symptoms in the first 2 weeks of the disease included a fever, severe lymphoproliferative syndrome, persistent purulent tonsillitis, and maculopapular rash. Severe hepatic damage developed on 20th day from the onset of the disease. The fact that the disease had an unusually severe course made it necessary to conduct differential diagnosis with lymphoproliferative and hemophagocytic syndromes. The child received the treatment with low-dose interferon agents (interferon α-2b) in suppositories, glucocorticoids (prednisone 3 mg/kg/day), intravenous immunoglobulins, symptomatic therapy. Acyclovir therapy was not administered. The patient made a complete recovery with full normalization of liver function.