ABSTRACT
Two patients developed fever, interstitial pneumonitis, and pancytopenia associated with extremely high titers of antibody to replicative antigens of the Epstein-Barr virus. In contrast to most patients seropositive for Epstein-Barr virus, neither patient had an antibody response to the Epstein-Barr nuclear antigen K polypeptide. In addition, virus isolated from one patient had a deletion of the B95-8 type in the EcoRI C region of the genome. An etiologic relation between Epstein-Barr virus replication and the clinical manifestations of this syndrome is further shown by the response of each patient to acyclovir therapy. These patients have a new Epstein-Barr-virus-associated syndrome and provide additional evidence that acyclovir may play a role in therapy for selected patients with Epstein-Barr virus infection.
Subject(s)
Acyclovir/therapeutic use , Fever/etiology , Herpesviridae Infections/complications , Pulmonary Fibrosis/etiology , Adolescent , Antibodies, Viral/analysis , Chronic Disease , Female , Genes, Viral , Herpesviridae Infections/drug therapy , Herpesviridae Infections/immunology , Herpesvirus 4, Human/genetics , Herpesvirus 4, Human/immunology , Herpesvirus 4, Human/physiology , Humans , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Lung/pathology , Virus ReplicationSubject(s)
Aortic Aneurysm/diagnosis , Aortic Valve Insufficiency/etiology , Adult , Aorta, Thoracic , Aortic Diseases/diagnosis , Arteritis/diagnosis , Diagnosis, Differential , Female , Giant Cell Arteritis/diagnosis , Heart Murmurs , Humans , Male , Spondylitis, Ankylosing/complications , Takayasu Arteritis/diagnosisABSTRACT
Mechanical complications of prosthetic valves are increasingly rare. The acute, catastrophic nature of the symptoms associated with massive transvalvular regurgitation preclude survival except with immediate operation. In the patient described herein, two weld fractures of a Björk-Shiley mitral prosthetic strut led to displacement of the valve occluder into the left atrium. The patient survived reoperation, following which the strut was detected radiologically in the left ventricular free wall. A slow, limited recovery resulted from his 5 preoperative hours of deep shock and coma. No complication attributable to the retained ventricular foreign body has been identified.