Japanese spotted fever with acute hepatic failure: was it associated with Epstein-Barr virus?

BACKGROUND

An 81-year-old female experiencing high fever, fatigue, and loss of appetite was admitted to our hospital and diagnosed with acute cholecystitis. Her condition did not improve and an eschar and erythema subsequently appeared. We then diagnosed Japanese spotted fever (JSF). She recovered immediately after the administration of minocycline. This case differed from other cases because the patient had a remarkably acute hepatic failure.

METHODS

Considering that the present case might be associated with other factors, we performed a repeat polymerase chain reaction (PCR) test on the patient's blood that had been collected on admission and stored.

RESULTS

Epstein-Barr virus (EBV) was detected in her blood by PCR.

CONCLUSIONS

We consider this case might be associated with EBV.