Acute primary Epstein-Barr virus infection in a well-to-do man: Existence in the area with high rate of seropositivity

Dear Sir,

Epstein-Barr virus (EBV) infection is a common viral infection that can be seen around the world. This virus is easily transmittable and can cause important disease, infectious mononucleosis, in pediatric population. ^[1] In the area with good public health system, the existence of disease can be seen in adult. However, in several tropical developing countries where the sanitation is not good, the high rate of seropositivity can be observed in adulthood and primary EBV infection in immunocompetent adulthood is extremely rare in those settings. Here, the authors experience a case of acute primary EBV infection in a well-to-do man (24 years old) in Bangkok, Thailand. The primary complaint is the repeated oral ulcer, sore throat, and mild eye lid swelling. The patient also presented low-graded fever. He had got antibiotic, but the symptom did not improve. The patient consulted to the physician and ordered for serological test for EBV and the primary EBV infection was confirmed by rising immunoglobulin G titer. This case was suggested to have antiviral therapy and supplementation (zinc and vitamin C). This case got recovery within 10 days. Of interest, the situation of EBV seropositivity in Thailand is the same as many developing countries. The rate of seropositive is generally 100% and the diagnosis of acute primary EBV in adult is extremely rare. ^[2] However, the present case shows that there is still a chance, especially in the well-to-do group. In the present case, an interesting clinical presentation on eye symptom can also be seen. ^[3]

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.133758