Epstein-Barr Virus-Induced Acute Pancreatitis-A Case Report and a Review of Literature.

Background and Clinical Significance: Epstein-Barr virus (EBV) is a common infection that rarely causes acute pancreatitis. EBV-associated acute pancreatitis is an uncommon but potentially serious complication that may result from direct viral invasion of pancreatic tissue or immune-mediated inflammation. Because its presentation can overlap with other causes of acute pancreatitis, EBV may be overlooked when common aetiologies are not identified. Recognising EBV as a potential cause is important for accurate diagnosis and appropriate management, particularly in patients presenting with pancreatitis alongside features of acute EBV infection; Case Presentation: We report a case of 58-year-old female with EBV-induced acute pancreatitis. She had a flu like illness two weeks prior to hospital admission, tested positive for EBV IgM antibodies and received supportive treatment by her general practitioner. However, her condition deteriorated, leading to hospital admission. She developed epigastric pain and investigations showed elevated serum lipase, impaired liver function tests and acute kidney injury. CT abdomen showed hepatosplenomegaly, lymphadenopathy and peripancreatic oedema consistent with acute pancreatitis. She was initially treated with antibiotics, however; her condition worsened and she developed severe hypotension requiring intensive care admission. Aggressive fluid resuscitation, inotropic support and continuous veno-venous haemofiltration (CVVH) were required. She gradually improved and subsequently was stepped down to the medical ward for supportive care and rehabilitation. She made full recovery and was discharged home after a 6-week length of stay;

Conclusions

EBV-associated acute pancreatitis is an uncommon but potentially severe complication of EBV infection. EBV should be considered in patients with acute pancreatitis when common aetiologies have been excluded, particularly when pancreatitis occurs alongside features of acute viral infection. Early recognition and appropriate supportive management may be important in preventing or limiting severe complications.