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Successful outcome of Epstein–Barr virus encephalitis managed with bilateral craniectomy, corticosteroids and aciclovir
  1. Emma Hayton1,
  2. Benjamin Wakerley2,
  3. Ian CJW Bowler1,
  4. Marko Bogdanovic3,
  5. Jane Elizabeth Adcock2
  1. 1Department of Microbiology, John Radcliffe Hospital, Oxford, UK
  2. 2Department of Neurology, John Radcliffe Hospital, Oxford, UK
  3. 3Department of Neurology, Royal Berkshire Hospital, Reading, UK
  1. Correspondence to Jane Elizabeth Adcock, Department of Neurology, John Radcliffe Hospital, West Wing, Headley Way, Oxford, Oxon OX3 9DU, UK; jane{at}


We present a 19-year-old woman with severe encephalitis and raised intracranial pressure requiring decompressive craniectomy. Her clinical features were consistent with encephalitis in the context of acute primary Epstein–Barr virus (EBV) infection (infectious mononucleosis). Serology, bone marrow aspirate and PCR of blood and cerebrospinal fluid confirmed the diagnosis. She was treated with corticosteroids and aciclovir. She was critically unwell for 3 weeks, requiring artificial ventilation but eventually made a good recovery. EBV encephalitis is uncommon, making the diagnosis and decisions about clinical management challenging.

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Benedict Michael, Liverpool, UK.

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