2017 Volume 49 Issue 4 Pages 279-282
A 10-year-old boy was admitted to the hospital complaining of a fever of 7 days' duration and myalgia. He had undergone renal transplantation at the age of seven due to chronic renal failure and had been receiving immunosuppressive agents. On admission, he complained of severe pain in his lower extremities and difficulty walking. Based on elevated serum creatine kinase, acute viral myositis was diagnosed. Seven days after admission, however, urinary incontinence as well as sensory disturbances in the hip and genitalia became evident. Based on the presence of Epstein-Barr virus (EBV) DNA in the cerebrospinal fluid and abnormal signals on MRI of the spinal cord at levels lower than Th8, EBV-associated myelitis was diagnosed. Immunosuppressive agents were reduced, and administration of immunoglobulin, ganciclovir and steroids was started. His condition gradually recovered with minimal sequelae. The antibody titer against EBV confirmed the past infection, suggesting that his myelitis might have been caused by EBV reactivation. This case indicates that reactivating EBV should be considered as a potential cause of myelitis in immunosuppressed patients.
