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CASE REPORT article

Front. Cell. Infect. Microbiol.
Sec. Clinical Microbiology
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1361119

Mycobacterium tuberculosis combine with EBV infection in severe adult meningoencephalitis：A rare case reports and literature review

Provisionally accepted
Wang Jian Wang Jian 1*Li M. Jiao Li M. Jiao 2Zhu J. Chi Zhu J. Chi 2Cheng L. Juan Cheng L. Juan 2Kong Ping Kong Ping 2
  • 1 Department of Neurology, Affiliated Aerospace Hospital of Zunyi Medical University, Guizhou, China, Zunyi, China
  • 2 Department of Neurology, Affiliated Hospital of Zunyi Medical College, Zunyi, China

The final, formatted version of the article will be published soon.

    Background Tuberculous meningitis (TBM) with adults Epstein-Barr (EB) virus encephalitis is a very rare infectious disease, with a high mortality and disability. Metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) is highly diagnostic. We report on a case of severe meningoencephalitis caused by co-infection with mycobacterium tuberculosis and EB virus. Brain MRI indicated a parenchyma lesion in the brain. mNGS of CSF indicated Mycobacterium tuberculosis and EB virus amplification, positive serum EB virus IgG antibodies, and improved symptoms after anti-tuberculosis and antiviral treatment. A re-examination of the brain MRI revealed that the significantly absorption of the lesions.Case report A 49-year-old male patient presented with a chief complaint of headache and fever with consciousness disturbance. The brain magnetic resonance imaging showed a lesions in the right parenchymal brain with uneven enhancement, accompanied by significantly increased intracranial pressure, elevated CSF cell count and protein levels, as well as notably decreased glucose and chloride levels. mNGS of CSF showed the coexistence of Mycobacterium tuberculosis and EBV. The patient was diagnosed as TBM with EBV encephalitis. The patient's symptoms gradually improved with the active administration of anti-tuberculosis combined with antiviral agents, the use of hormones to reduce inflammatory reaction, dehydration to lower intracranial pressure, and intrathecal injection. Subsequent follow-up brain magnetic resonance imaging indicated significant absorption of the lesions, along with a marked decrease in CSF count and protein levels, as well as obvious increase in glucose and chloride levels.TBM associated with adult EBV encephalitis is extremely rare. The disease's early stages are severe and have a high fatality rate. A prompt and accurate diagnosis is particularly important. NGS of CSF is of great value for early diagnosis.

    Keywords: tuberculous meningitis, Epstein-Barr virus, Meningoencephalitis, metagenomic next-generation sequencing, case report

    Received: 08 Jan 2024; Accepted: 30 Aug 2024.

    Copyright: © 2024 Jian, Jiao, Chi, Juan and Ping. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wang Jian, Department of Neurology, Affiliated Aerospace Hospital of Zunyi Medical University, Guizhou, China, Zunyi, China

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