Chronic active Epstein–Barr virus infection mimicking tuberculosis – A diagnostic enigma

Chronic active EBV infection is a rare disorder prone for misdiagnosis. They present with a wide range of symptoms from indolent to aggressive clinical course. Clinico-pathological correlation with confirmation by ancillary techniques is inevitable to diagnose this disease. We present a case of a 29...

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Main Authors: Shilpi Thakur, Manish Soneja, Deepam Pushpam, Saumyaranjan Mallick
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Indian Journal of Pathology and Microbiology
Subjects:
Online Access:https://journals.lww.com/10.4103/ijpm.ijpm_774_22
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author Shilpi Thakur
Manish Soneja
Deepam Pushpam
Saumyaranjan Mallick
author_facet Shilpi Thakur
Manish Soneja
Deepam Pushpam
Saumyaranjan Mallick
author_sort Shilpi Thakur
collection DOAJ
description Chronic active EBV infection is a rare disorder prone for misdiagnosis. They present with a wide range of symptoms from indolent to aggressive clinical course. Clinico-pathological correlation with confirmation by ancillary techniques is inevitable to diagnose this disease. We present a case of a 29-year-old male with fever, weight loss, and lymphadenopathy for 6 months. Lymph node biopsy showed occasional granuloma with preserved architecture. Suspected to have tuberculosis, he received antitubercular treatment (ATT) with no response for 3 months. Subsequently, additional workup showed many EBV-positive cells in sinusoids with high serum EBV titer, confirming the difficult diagnosis of CAEBV. The present case highlights the difficulty in the diagnosis of this entity and also emphasizes the necessity to recognize this disorder in countries endemic for tuberculosis, as it is no longer bound by ethnicity and geographical boundaries.
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publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
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series Indian Journal of Pathology and Microbiology
spelling doaj-art-f699ba42a55943cf9a95800aefce2dec2025-08-20T02:09:14ZengWolters Kluwer Medknow PublicationsIndian Journal of Pathology and Microbiology0377-49290974-51302025-01-0168115515710.4103/ijpm.ijpm_774_22Chronic active Epstein–Barr virus infection mimicking tuberculosis – A diagnostic enigmaShilpi ThakurManish SonejaDeepam PushpamSaumyaranjan MallickChronic active EBV infection is a rare disorder prone for misdiagnosis. They present with a wide range of symptoms from indolent to aggressive clinical course. Clinico-pathological correlation with confirmation by ancillary techniques is inevitable to diagnose this disease. We present a case of a 29-year-old male with fever, weight loss, and lymphadenopathy for 6 months. Lymph node biopsy showed occasional granuloma with preserved architecture. Suspected to have tuberculosis, he received antitubercular treatment (ATT) with no response for 3 months. Subsequently, additional workup showed many EBV-positive cells in sinusoids with high serum EBV titer, confirming the difficult diagnosis of CAEBV. The present case highlights the difficulty in the diagnosis of this entity and also emphasizes the necessity to recognize this disorder in countries endemic for tuberculosis, as it is no longer bound by ethnicity and geographical boundaries.https://journals.lww.com/10.4103/ijpm.ijpm_774_22chronic infectionebvlymphomat/nk lpdtuberculosis
spellingShingle Shilpi Thakur
Manish Soneja
Deepam Pushpam
Saumyaranjan Mallick
Chronic active Epstein–Barr virus infection mimicking tuberculosis – A diagnostic enigma
Indian Journal of Pathology and Microbiology
chronic infection
ebv
lymphoma
t/nk lpd
tuberculosis
title Chronic active Epstein–Barr virus infection mimicking tuberculosis – A diagnostic enigma
title_full Chronic active Epstein–Barr virus infection mimicking tuberculosis – A diagnostic enigma
title_fullStr Chronic active Epstein–Barr virus infection mimicking tuberculosis – A diagnostic enigma
title_full_unstemmed Chronic active Epstein–Barr virus infection mimicking tuberculosis – A diagnostic enigma
title_short Chronic active Epstein–Barr virus infection mimicking tuberculosis – A diagnostic enigma
title_sort chronic active epstein barr virus infection mimicking tuberculosis a diagnostic enigma
topic chronic infection
ebv
lymphoma
t/nk lpd
tuberculosis
url https://journals.lww.com/10.4103/ijpm.ijpm_774_22
work_keys_str_mv AT shilpithakur chronicactiveepsteinbarrvirusinfectionmimickingtuberculosisadiagnosticenigma
AT manishsoneja chronicactiveepsteinbarrvirusinfectionmimickingtuberculosisadiagnosticenigma
AT deepampushpam chronicactiveepsteinbarrvirusinfectionmimickingtuberculosisadiagnosticenigma
AT saumyaranjanmallick chronicactiveepsteinbarrvirusinfectionmimickingtuberculosisadiagnosticenigma