Microbiology Case 121 May 3, 2023 pathadmin 3,159 Comments 1. Prepared by Curtis Gravenmier MD and reviewed by Heba Mostafa MBBCh, PhD, D(ABMM)An HIV-positive adult with absolute CD3+CD4+ lymphocyte count of 400 is brought to the hospital with fever, somnolence, and both stool and urine incontinence. The initial evaluation is remarkable for tachycardia, hypotension, and granulocytosis with left shift. A chest x-ray shows patchy opacities in the right upper lobe and bilateral lung bases, and a Streptococcus pneumoniae urine antigen test is positive. The patient responds well to fluid resuscitation and empiric therapy for bacterial pneumonia. Altered mental status persists, however, prompting lumbar puncture. The cerebrospinal fluid shows a lymphocytic pleocytosis, elevated total protein, and Epstein-Barr virus DNA is detected using qualitative real-time PCR. Spinal fluid cultures and a cryptococcal antigen test are negative.QuestionWhich of the following is incorrect regarding Epstein-Barr virus (EBV)?A. EBV has a linear double-stranded DNA genome.B. EBV has been identified in smooth muscle tumors associated with immunocompromise.C. EBV can persist in a latent form within memory B-cells.D. EBV cytopathologic changes include degenerative vacuoles, cytomegaly, karyomegaly, hyperchromasia, and bizarre nuclear shapes with possible multinucleation. E. EBV DNA can be detected in CSF of individuals with latent infection due to viral reactivation in the setting of meningitis. Loading...
