Case Report of Epstein–Barr Virus (EBV) Meningitis with Arachnoiditis in a Previously Healthy Patient.

Epstein-Barr virus (EBV) is from herpesviridae family that is spread by close contact between susceptible persons and asymptomatic EBV carriers. EBV is the most common causative agent of infectious mononucleosis (IM), that persists asymptomatically for life in nearly all adults. It is associated with the development of B cell lymphomas, T cell lymphomas, Hodgkin lymphoma and nasopharyngeal carcinomas in certain patients. EBV is associated with a variety of CNS complications which can occur in the absence of clinical or laboratory manifestations of infectious mononucleosis. EBV meningoencephalitis should always be considered as one of the causative agents in immunocompetent patients who present with clinical features of meningitis. Molecular diagnostic techniques using CSF PCR and blood samples provides prompt diagnosis. Neuroimaging with MRI provides neuroanatomic localization of EBV meningoencephalitis, which may be a prognostic factor. The purpose of this case report is to increase the awareness of health care professionals about EBV meningoencephalitis as an under-diagnosed disease, and emphasize that excellent outcome can be achieved by early treatment. In this case report, we review a young male, with no significant past medical history, who presented with acute EBV meningitis, and was successfully treated medically.

A Case Report of Invasive Meningococcal Disease in an Adult without Identifiable Risk Factors.

Meningitis is the most common manifestation of invasive meningococcal disease (IMD), occurring in approximately 50% of all cases. It is characterized by sudden onset, very rapid progression, and a high case fatality rate even with early and appropriate treatment. The purpose of this case report is to increase the awareness of health care professionals about the seriousness of IMD, so it should be considered in differential diagnosis with top priority in certain cases even in absence of risk factors, and emphasize that excellent outcome can be achieved by early employment of appropriate therapy. In this case report, we review an adult male, with no past medical history of significance, who presented with IMD, and was successfully treated in the intensive care unit with prompt initiation of IV antibiotics, ventilation support and multidisciplinary approach in management.

Case Report of Rhino-Orbital Mucormycosis in a Diabetic, with Excellent Outcome.

Acute sinusitis secondary to virulent organisms can initially be subtle, or might be misdiagnosed as viral sinusitis. It is one of the most common diagnoses we face in clinical practice. Among all the variable etiologies, fungal sinusitis is the most obscure with devastating consequences. The purpose of this case report is to increase the awareness of health care professionals about invasive fungal sinusitis as an under-diagnosed disease, and emphasize that excellent outcome can be achieved by early employment of different therapeutic modalities. In this case report, we review an older adult male, with significant cardiac and diabetes history, who presented with acute rhino-orbital mucormycosis, and was successfully treated with prompt endoscopic surgical debridement, dual IV antifungals, local amphotericin B nasal washing, and hyperbaric oxygen therapy. All of the above led to extremely favorable outcome for such an aggressive infection.