Chronic Epstein-Barr Virus Infection Associated with Fever and Interstitial Pneumonitis

Clinical and Serologic Features and Response to Antiviral Chemotherapy

  1. ROBERT T. SCHOOLEY, M.D.;
  2. ROBERT W. CAREY, M.D.;
  3. GEORGE MILLER, M.D.;
  4. WERNER HENLE, M.D.;
  5. ROBIN EASTMAN, B.S.;
  6. EUGENE J. MARK, M.D.;
  7. KENNETH KENYON, M.D.;
  8. EDWIN O. WHEELER, M.D.; and
  9. ROBERT H. RUBIN, M.D.
  1. Boston Massachusetts; New Haven, Connecticut; and Philadelphia, Pennsylvania

    Abstract

    Two patients developed fever, interstitial pneumonitis, and pancytopenia associated with extremely high titers of antibody to replicative antigens of the Epstein-Barr virus. In contrast to most patients seropositive for Epstein-Barr virus, neither patient had an antibody response to the Epstein-Barr nuclear antigen K polypeptide. In addition, virus isolated from one patient had a deletion of the B95-8 type in the EcoRI C region of the genome. An etiologic relation between Epstein-Barr virus replication and the clinical manifestations of this syndrome is further shown by the response of each patient to acyclovir therapy. These patients have a new Epstein-Barr-virus-associated syndrome and provide additional evidence that acyclovir may play a role in therapy for selected patients with Epstein-Barr virus infection.

    Article and Author Information

    • ▸From the Infectious Disease, Hematology-Oncology, and Cardiology Units, Medical Services, and the Department of Pathology, Massachusetts General Hospital, and the Cornea Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; the Departments of Pediatrics, Molecular Biology, and Biophysics, Yale University School of Medicine, New Haven, Connecticut; and the Joseph Stokes Jr. Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

    • Grant support: in part by grants CA37461, CA33324, and AI14741 from the National Institutes of Health; and by the Mashud Mezerhane B Fund.

    • ▸Requests for reprints should be addressed to Robert T. Schooley, M.D.; Infectious Diseases Unit, Massachusetts General Hospital; Boston, MA 02114.

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    1. Ann Intern Med May 1, 1986 vol. 104 no. 5 636-643
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