Intracranial hypertension due to Epstein-Barr virus encephalitis during the postpartum period A case report
Keywords:
adult, brain edema, cerebrospinal fluid, Epstein-Barr virus infections, intracranial pressure, intracranial hypertension, treatment outcome, postpartum period, encephalitisArticle Sidebar
Main Article Content
Case Description
A 28-year-old postpartum woman presented with severe headache, fever, and decreased level of consciousness. Cerebrospinal fluid PCR detected 185,000 copies of Epstein-Barr virus DNA.
Clinical Findings
Neuroimaging revealed diffuse cerebral edema consistent with intracranial hypertension in the absence of hemorrhagic lesions, confirming Epstein-Barr virus encephalitis complicated by objectively documented elevated intracranial pressure.
Treatment and Outcomes
The patient received intravenous acyclovir, phenytoin, and hypertonic saline, achieving complete neurological recovery after 21 days of therapy.
Clinical Relevance
To our knowledge, this is the first documented case of non-hemorrhagic Epstein-Barr virus encephalitis with objectively confirmed intracranial hypertension in the postpartum period. The most plausible mechanism is inflammation-induced diffuse cerebral edema leading to impaired cerebrovascular autoregulation and subsequent intracranial pressure elevation. Clinicians should include Epstein-Barr virus infection in the differential diagnosis of postpartum patients presenting with encephalitis and signs of increased intracranial pressure, even when neuroimaging does not reveal hemorrhagic findings.
María Fernanda García, Universidad Central del Ecuador
https://orcid.org/0000-0002-5375-3474
Universidad Central del Ecuador, Facultad de Ciencias Médicas, Unidad de Revisiones Sistemáticas y Metaanálisis (URMA), Quito, Ecuador.
Hospital de Especialidades Eugenio Espejo, Quito, Ecuador.
Luis Fuenmayor Gonzalez, Washington University
https://orcid.org/0000-0001-6141-7692
Washington University, School of Public Health, St. Louis, USA.
Zero Biomedical Research, Quito, Ecuador
Nelson Remache, Hospital de Especialidades Eugenio Espejo
https://orcid.org/0009-0009-9950-2740
Hospital de Especialidades Eugenio Espejo, Quito, Ecuador.
Jorge Jimenez, Hospital de Especialidades Eugenio Espejo
https://orcid.org/0009-0001-5967-3563
Hospital de Especialidades Eugenio Espejo, Quito, Ecuador.
Daniel Peñaherrera, Universidad Central del Ecuador
https://orcid.org/0009-0008-2299-5850
Universidad Central del Ecuador, Facultad de Ciencias Médicas, Unidad de Revisiones Sistemáticas y Metaanálisis (URMA), Quito, Ecuador.
Hospital Quito N°1, Policía Nacional del Ecuador, Quito, Ecuador
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