Chronic active Epstein‒Barr virus colitis, a rare cause of recurrent diarrhea in an immunocompetent female: a case report

Abstract Background Chronic active Epstein-Barr virus (CAEBV) colitis is a rare disease with clinical and endoscopic manifestations very similar to those of inflammatory bowel disease (IBD). In clinical practice, it is easy to be misdiagnosed and mistreated, leading to poor clinical outcomes. Case p...

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Main Authors: Mei Liang, Junyan Qu
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-024-10422-z
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author Mei Liang
Junyan Qu
author_facet Mei Liang
Junyan Qu
author_sort Mei Liang
collection DOAJ
description Abstract Background Chronic active Epstein-Barr virus (CAEBV) colitis is a rare disease with clinical and endoscopic manifestations very similar to those of inflammatory bowel disease (IBD). In clinical practice, it is easy to be misdiagnosed and mistreated, leading to poor clinical outcomes. Case presentation We report a case of a 56-year-old Chinese woman who presented with 6 years of intermittent severe diarrhea, fever, and abdominal pain. Ulcerative colitis was initially suspected. The patient’s clinical symptoms were partially relieved after treatment with mesalazine and probiotics. However, the symptoms were repeated and improved after supportive and symptomatic treatment each time. Colonoscopy revealed multiple mucosal erosion and edema in the colon, EBV-encoded small RNA 1/2 in situ hybridization in the pathological tissue of the colon was positive (20/HP), and EBVDNA in the peripheral blood was positive. CAEBV colitis was diagnosed. The patient was given dexamethasone and acyclovir, and she was improved after treatment. Unfortunately, she was discharged without outpatient follow-up, and similar symptoms recurred one year later, with similar colonoscopy and pathological examinations. Symptoms were relieved after dexamethasone treatment. Conclusion This case highlights the diagnostic challenges posed by nonspecific clinical manifestations of CAEBV colitis, which should be included as a differential diagnosis in patients with recurrent diarrhea and fever to avoid misdiagnosis.
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spelling doaj-art-e4bd95243514490aa06d9ca8cfcdf57d2025-08-20T02:40:39ZengBMCBMC Infectious Diseases1471-23342025-01-012511510.1186/s12879-024-10422-zChronic active Epstein‒Barr virus colitis, a rare cause of recurrent diarrhea in an immunocompetent female: a case reportMei Liang0Junyan Qu1Center of Infectious Disease, West China Hospital, Sichuan UniversityCenter of Infectious Disease, West China Hospital, Sichuan UniversityAbstract Background Chronic active Epstein-Barr virus (CAEBV) colitis is a rare disease with clinical and endoscopic manifestations very similar to those of inflammatory bowel disease (IBD). In clinical practice, it is easy to be misdiagnosed and mistreated, leading to poor clinical outcomes. Case presentation We report a case of a 56-year-old Chinese woman who presented with 6 years of intermittent severe diarrhea, fever, and abdominal pain. Ulcerative colitis was initially suspected. The patient’s clinical symptoms were partially relieved after treatment with mesalazine and probiotics. However, the symptoms were repeated and improved after supportive and symptomatic treatment each time. Colonoscopy revealed multiple mucosal erosion and edema in the colon, EBV-encoded small RNA 1/2 in situ hybridization in the pathological tissue of the colon was positive (20/HP), and EBVDNA in the peripheral blood was positive. CAEBV colitis was diagnosed. The patient was given dexamethasone and acyclovir, and she was improved after treatment. Unfortunately, she was discharged without outpatient follow-up, and similar symptoms recurred one year later, with similar colonoscopy and pathological examinations. Symptoms were relieved after dexamethasone treatment. Conclusion This case highlights the diagnostic challenges posed by nonspecific clinical manifestations of CAEBV colitis, which should be included as a differential diagnosis in patients with recurrent diarrhea and fever to avoid misdiagnosis.https://doi.org/10.1186/s12879-024-10422-zChronic active Epstein-Barr virusChronic diarrheaInflammatory bowel diseaseMisdiagnosis
spellingShingle Mei Liang
Junyan Qu
Chronic active Epstein‒Barr virus colitis, a rare cause of recurrent diarrhea in an immunocompetent female: a case report
BMC Infectious Diseases
Chronic active Epstein-Barr virus
Chronic diarrhea
Inflammatory bowel disease
Misdiagnosis
title Chronic active Epstein‒Barr virus colitis, a rare cause of recurrent diarrhea in an immunocompetent female: a case report
title_full Chronic active Epstein‒Barr virus colitis, a rare cause of recurrent diarrhea in an immunocompetent female: a case report
title_fullStr Chronic active Epstein‒Barr virus colitis, a rare cause of recurrent diarrhea in an immunocompetent female: a case report
title_full_unstemmed Chronic active Epstein‒Barr virus colitis, a rare cause of recurrent diarrhea in an immunocompetent female: a case report
title_short Chronic active Epstein‒Barr virus colitis, a rare cause of recurrent diarrhea in an immunocompetent female: a case report
title_sort chronic active epstein barr virus colitis a rare cause of recurrent diarrhea in an immunocompetent female a case report
topic Chronic active Epstein-Barr virus
Chronic diarrhea
Inflammatory bowel disease
Misdiagnosis
url https://doi.org/10.1186/s12879-024-10422-z
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AT junyanqu chronicactiveepsteinbarrviruscolitisararecauseofrecurrentdiarrheainanimmunocompetentfemaleacasereport