Pekova L¹*, Angelova S², Parusheva P¹ and Mitev M³

¹Department of Infectious Diseases, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
²Department of Microbiology, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
³Department of Imaging Diagnostic, Medical Faculty, Trakia University, Stara Zagora, Bulgaria

*Corresponding Author: Pekova L, Department of Infectious Diseases, Medical Faculty, Trakia University, Stara Zagora, Bulgaria.

Received: April 30, 2026; Published: May 31, 2026

Epstain-Barr virus (EBV) is a probably the most ubiquitous human virus, infecting 90-95% of the population worldwide. Primary EBV infection is usually asymptomatic and self-resolved when occurring in childhood. Yet neurological involvement of this virus is reported, usually in immunocompromised patients. We describe a case of immunocompetent 56-year-old male with relapsing EBV meningoencephalitis. He presented to the hospital with a 5-days history of flu-like symptoms. Neurological examination revealed obnubilation, bradypsychia and signs of meningeal irritation. Blood analysis showed mild inflammatory changes. Cerebro-spinal fluid (CSF) changes were consistent with those of aseptic meningoencephalitis – lymphocytic pleocytosis and hyperproteinorachia. PCR CSF viral and bacterial panel failed to provide a conclusive diagnosis. The patient was treated empirically with antibiotics, pathogenetically and symptomatically as well. He was discharged after a 15-days hospital stay in an improved condition. Two days later he was re-hospitalized with worsening of previous symptoms and development of new neurological disorders – unsteady gait and right hemiparesis. An acute cerebral-vascular incident was ruled out. The diagnosis of EBV meningoencephalitis was confirmed with evidence of EBV DNA in CSF by PCR. Serological blood tests with ELISA were positive for VCA IgG and negative for VCA IgM. This result is consistent with a reactivation of latent EBV infection. The patient was tested for immunodeficiency with negative results. He was treated with intravenous Aciclovir with good result.

Keywords: Recurrent EBV Meningoencephalitis; Immunocompetent Man

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Citation

Citation: Pekova L., et al. “A Case of Recurrent EBV Meningoencephalitis in a 56-Year-Old Man". Acta Scientific Medical Sciences 10.6 (2026): 89-95.

Copyright

Copyright: © 2026 Pekova L., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.