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Case Reports
. 2024 Jun 24;21(1):142.
doi: 10.1186/s12985-024-02418-7.

Chronic active Epstein-Barr virus infection with reinfection of SARS-CoV-2: a case report

Hongmei Wu  1 , Li Liu  2 , Jialin Qu  1 , Chunrui Wang  1 , Xiaofeng Shi  1 , Yu Lei  3
Affiliations
Case Reports

Chronic active Epstein-Barr virus infection with reinfection of SARS-CoV-2: a case report

Hongmei Wu et al. Virol J. .

Abstract

We describe the case of a 57-year-old male with jaundice, abdominal distension and fatigue. He was diagnosed as chronic active Epstein-Barr virus infection (CAEBV) due to intermittent elevated liver enzymes, hepatosplenomegaly and pancytopenia, with persistent positive of EBV biomarkers in blood and also positive in liver tissue. The patient was reinfected by SARS-CoV-2 within 2 months companied with CAEBV. The patient's second infection with SARS-CoV-2 led to the aggravated liver dysfunction with pneumonia and re-admission. After receiving symptomatic treatment, the patient showed significantly improvement of symptoms with partially restoration of liver function. After discharge, the patient's health status continued to deteriorate and eventually died. The instances of SARS-CoV-2 co-infection with the original chronic virus are not uncommon, but the exact mechanism of EBV and SARS-CoV-2 coinfection and the relationship between them are still unclear. Since co-infection of SARS-CoV-2 with original chronic virus might affect each other and lead disease aggravated and complicated, it is necessary to differentiate in the diagnosis of disease and it is important to be aware of the re-infection signs of SARS-CoV-2 in people with chronic virus infection diseases, as well as the risk of co-infection of SARS-CoV-2 with other viruses.

Keywords: Chronic active Epstein Barr virus (CAEBV); Co-infection; Reinfection; SARS-CoV-2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Contrast-enhanced MRI + DWI and Contrast-enhanced CT scan of the abdomen. Left panel: Abdominal magnetic resonance imaging (MRI) at July 2022; Right panel: Abdominal contrast enhanced CT scan at February 2023
Fig. 2
Fig. 2
Histology of liver. Left and middle panel: Hematoxylin-eosin (HE) staining of the liver tissue. Right panel: Epstein-Barr virus-encoded small RNAs in situ hybridization (EBER-ISH) of the liver tissue. Scale bars: 100 μm in upper panel and 50 μm in lower panel. The lesion is marked by: → Portal area and lobular inflammation, formula image hepatocellular and canalicular cholestasis, formula image steatosis of hepatocytes, formula image EBER-ISH positive lymphocytes
Fig. 3
Fig. 3
Lung CT scan. Lung CT scan imaging at February 2023. → signs of pulmonary diffuse inflammation
See this image and copyright information in PMC

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