Complicated EBV infection in a healthy child.

The Epstein-Barr virus (EBV) is highly prevalent throughout the population. Although in most cases, the infection has a good prognosis, it can cause severe complications. We report a case of a healthy child with a primary EBV infection that evolved with two rare complications. She first presented in the emergency room with fever and sore throat, and was diagnosed with tonsillitis and medicated with antibiotic. She returned 7 days later for fatigue, vomiting and abdominal pain. The examination revealed tonsillitis, swollen cervical lymph nodes and pain in the right hypochondrium. An abdominal ultrasound was performed, compatible with acute acalculous cholecystitis. She was admitted in the paediatric nursery and medicated with intravenous antibiotics. The EBV serology revealed primary infection. Two days later, she developed cardiogenic shock and had to be transferred to an intensive care unit under mechanical ventilation and inotropics. She was discharged 12 days later, keeping a moderate left ventricular dysfunction.

Transient mutism, pathological laughter and cerebellar ataxia after primary varicella-zoster virus infection.

Acute postinfectious cerebellitis is characterised by inflammatory involvement of the cerebellum and consequent cerebellar dysfunction, usually presenting a benign and self-limited course. Common symptoms described in the literature include ataxia, peripheral facial paralysis, aphasia, spinal dysfunction and eventually hydrocephalus. We describe a rare presentation of acute cerebellitis after varicella, in a 6-year-old child, who presented with ataxia, dysmetria, mutism and pathological laughter.