Chronic active Epstein-Barr virus infection featured with hydroa vacciniforme-like eruptions: a case report and literature review

Objective To summarize the characteristics of one case of chronic active Epstein-Barr virus infection（CAEBV）featured with hydroa vacciniforme（HV）, and analyze the highlights of diagnosis and treatment. Methods One case of CAEBV complicated with HV-like eruption was reported. Literature review was conducted from PubMed and CNKI by using keywords of ‘child/children’‘chronic active Epstein-Barr virus infection’ and ‘hydroa vacciniforme-like eruption’ both in Chinese and English. The data of the searched patients were collected and analyzed. Results The main manifestations of this patient included repeated fever and systemic lymph node enlargement accompanied by hydroa vacciniforme-like eruption. Laboratory examination showed the changes of EBV-related antibody titer in the peripheral blood and increased EBV-DNA load. Excluding the possibility of autoimmune and tumor diseases, the diagnosis of CAEBV was confirmed by the skin and lymph node pathology. The patient’s condition was improved and stable after treated with allogeneic hematopoietic stem cell transplantation. A total of 6 cases were retrieved, mainly distributed in East Asia. T lymphocytes were the main type of cells infected with EBV. Antiviral therapy and chemotherapy yielded poor clinical efficacy. Conclusions HV is a typical skin feature of CAEBV, which is helpful for early diagnosis of CAEBV. Stem cell transplantation is the most promising and effective treatment for CAEBV. Nevertheless, the timing of treatment is controversial. Prior to transplantation, the patients’ conditions should be comprehensively evaluated to determine the optimal treatment timing.