PDF(Pubmed)
Abstract：
Epstein-Barr virus (EBV) is a widely infectious pathogen affecting most of the global population at some point in their life. While, typically, primary infections are subclinical, chronic persistence of the virus due to T-cell proliferation can cause severe complications. Acute hepatitis due to chronic active EBV (CAEBV) has rarely been documented. This case details a previously healthy 81-year-old woman who presented with complaints of diffuse abdominal pain, nausea, and vomiting. Her diagnostic workup demonstrated an EBV infection with worsening thrombocytopenia, transaminitis, and hepatocellular liver injury with acute ascites. Her hospitalization was resistant to the traditional supportive treatment of EBV, requiring intensive care management and unorthodox therapy. Although antivirals have demonstrated limited utility in the treatment of CAEBV, the severity of her illness and refractory hospital course necessitated the use of acyclovir. She made a complete recovery with no deficits. The case demonstrates the presentation of acute hepatitis and ascites as a result of CAEBV, the clinical sequelae, and acyclovir as a potential new treatment option.
摘要：
爱泼斯坦-巴尔病毒（EBV）是一种广泛的传染性病原体，在其生命的某个时刻影响着全球大多数人口。同时,通常，原发性感染是亚临床的，T细胞增殖导致的病毒慢性持续存在可引起严重并发症.由于慢性活动性EBV（CAEBV）引起的急性肝炎很少被记录。此病例详述了一名先前健康的81岁女性，她主诉弥漫性腹痛，恶心,和呕吐。她的诊断检查显示EBV感染伴血小板减少症恶化,转胺炎,和急性腹水肝细胞肝损伤。她的住院对传统的EBV支持性治疗有抵抗力，需要重症监护管理和非正统治疗。尽管抗病毒药物在治疗CAEBV中的应用有限，她病情的严重程度和住院期间的难愈性，因此必须使用阿昔洛韦。她完全康复，没有赤字。该病例显示CAEBV导致急性肝炎和腹水，临床后遗症，和阿昔洛韦作为一个潜在的新的治疗选择。
