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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2025-01-01
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| 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. |
| format | Article |
| id | doaj-art-e4bd95243514490aa06d9ca8cfcdf57d |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| 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 |
| work_keys_str_mv | AT meiliang chronicactiveepsteinbarrviruscolitisararecauseofrecurrentdiarrheainanimmunocompetentfemaleacasereport AT junyanqu chronicactiveepsteinbarrviruscolitisararecauseofrecurrentdiarrheainanimmunocompetentfemaleacasereport |