Acute gastritis associated with Epstein-Barr virus infection in a child

Abstract

Infectious mononucleosis is Epstein-Barr virus (EBV) inducing a self-limiting clinical syndrome characterized by fever, sore throat, hepatosplenomegaly, and generalized lymphadenopathy. Gastrointestinal symptoms of EBV infection are nonspecific and occur rarely. EBV inducing acute gastrointestinal pathology is poorly recognized without suspicion. Careful consideration is needed to diagnose gastric involvement of EBV infection including gastric lymphoma, gastric cancer, and gastritis. A few recent cases of gastritis associated with EBV infection have been reported in adolescents and adults. However, there is no report of EBV-associated gastritis in early childhood. We experienced a rare case of 4-year-old girl with EBV gastritis confirmed by in situ hybridization.

Keywords: Epstein-Barr virus; Gastritis; In situ hybridization; Infectious mononucleosis.

Fig. 1. Diffuse wall thickening of the stomach (*) detected by computed topographic scan (A), and diffuse edematous gastric mucosa was noted in the body and antrum (B).

Fig. 2. Microscopic findings. (A) There is diffuse atypical lymphocytes proliferation in the lamina propria (H&E, ×100). (B, C) These cells are positive for CD20 (B) and CD3 (C) (immunohistochemistry, ×200). (D) It shows also positive for Epstein-Barr virus-encoded small RNA staining (in situ hybridization method, ×200)