A case of severe chronic active infection with Epstein-Barr virus: Immunologic deficiencies associated with a lytic virus strain

Infectious mononucleosis (IM) is a self-limiting, lymphoproliferative disea se induced by primary infection with the Epstein-Barr virus (EBV). Infectio n with EBV leads in general to lifelong asymptomatic persistence of the vir us. We report the case of a woman who acquired IM at the age of 15 years an d then suffered from recurrent high fever, fatigue, and signs of immunologi c disorder for more than 12 years until she died of liver failure, In an at tempt to describe and to define the course of chronic active infection with EBV, we performed immunologic and molecular assays that demonstrated lytic replication of EBV in the B and T cells of the peripheral blood. In additi on to signs of humoral and cellular immune deficiency, we detected an EBV s train with an impaired capability to immortalize B cells and a tendency to lytic replication, thus contributing to the pathogenesis of this chronic ac tive infection.