[Pancreatitis, myocarditis and interstitial nephritis associated with acute infection with Epstein Barr virus].

BACKGROUND

Epstein-Barr virus (EBV) is a widely disseminated herpesvirus that is spread by intimate contact between susceptible persons and asymptomatic EBV shedders. Clinical manifestations range from uncomplicated infectious mononucleosis to Burkitt lymphoma. The majority of primary EBV infections throughout the world are subclinical, after a prodromal period of feverishness, and malaise, the disease presents with the classic triad of severe sore throat, fever and lymphadenopathy. In some cases an atypical presentation can occur that may lead to potentially fatal complication.

METHODS

A 39-year-old woman was admitted because of abdominal pain, nausea and vomiting; one week before admission the patient noticed sore throath and fever. During hospitalization an acute pancreatitis was documented with elevated serum amylase and Balthazar B CT, in addition to an acute renal failure; subsequently presented respiratory failure and distributive shock associated to myocardial injury. These serious complications progressively resolved with supportive measures. The final diagnosis was pancreatitis, myocarditis and acute renal failure due to Epstein-Barr virus, confirmed by serological markers.

CONCLUSIONS

EBV can affect virtually any organ system and can have a variety of clinical presentations. It should be considered in the differential diagnosis of febrile processes of unknown etiology with multisystem involvement.