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7 pages, 571 KiB  
Case Report
Headache, Fever, and Myalgias in an HIV-Positive Male with a History of Tuberculosis: Epstein–Barr Virus Aseptic Meningitis
by Loukas Kakoullis, Claudia Hentschel and Robert Colgrove
Trop. Med. Infect. Dis. 2023, 8(4), 191; https://doi.org/10.3390/tropicalmed8040191 - 26 Mar 2023
Cited by 2 | Viewed by 2230
Abstract
Background: We describe a case of EBV aseptic meningitis in a patient with HIV with an extensive history of prior infections and exposures. Detailed Case Description: A 35-year-old man with a history of HIV, syphilis, and partially treated tuberculosis presented with headache, fever, [...] Read more.
Background: We describe a case of EBV aseptic meningitis in a patient with HIV with an extensive history of prior infections and exposures. Detailed Case Description: A 35-year-old man with a history of HIV, syphilis, and partially treated tuberculosis presented with headache, fever, and myalgias. He reported recent exposure to dust from a construction site and had sexual contact with a partner with active genital lesions. An initial workup revealed mildly elevated inflammatory markers, significant pulmonary scarring from tuberculosis with a classic “weeping willow sign”, and lumbar puncture findings consistent with aseptic meningitis. An extensive evaluation was conducted to identify causes of bacterial and viral meningitis, including syphilis. Immune reconstitution inflammatory syndrome and isoniazid-induced aseptic meningitis were also considered based on his medications. EBV was ultimately isolated through PCR from the patient’s peripheral blood. The patient’s condition improved, and he was discharged on his home antiretroviral and anti-tuberculous treatment. Conclusion: Central nervous system infections represent unique challenges in patients with HIV. EBV reactivation can present with atypical symptoms and should be considered as a cause of aseptic meningitis in this population. Full article
(This article belongs to the Special Issue From Bedside to Exposure: Infections of Leisure)
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