{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T06:04:12Z","timestamp":1780985052626,"version":"3.54.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The co-occurrence of MOG and NMDAR antibodies has been reported in a limited number of cases and is termed the overlapping syndrome (MNOS). Viral coinfections have been identified in a subset of patients with MNOS. Herein, we report the first case of MNOS with concomitant cytomegalovirus (CMV) infection detected in cerebrospinal fluid, a finding that helps to further explore the relationship between viral infection and MNOS. A previously healthy 49-year-old man developed fever and behavioral abnormalities following prodromal symptoms. Metagenomic next-generation sequencing (NGS) of the CSF identified CMV DNA with high confidence (specific reads: 362; relative abundance: 85.97%). Serology was positive for CMV IgG but negative for IgM; serum CMV-DNA detected by real-time PCR was negative. Positivity for anti-NMDAR antibodies and anti-MOG antibodies in the CSF, whereas only anti-MOG antibodies were detected in the serum. The patient\u2019s condition gradually improved after treatment with antiviral agents, corticosteroids, and intravenous immunoglobulin. The main limitations of this report include the lack of detection of CMV-DNA in CSF by real-time PCR, as well as the absence of dynamic assessment of serum\/CSF CMV IgG\/IgM, anti-NMDAR, and MOG antibody titers. Clinical vigilance for coexisting autoimmune encephalitis should be heightened following viral infections.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1805851","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:43:44Z","timestamp":1780983824000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti-NMDAR and anti-MOG antibody double-positive encephalitis temporally associated with cytomegalovirus detection in cerebrospinal fluid: a case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Rujue","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Neurology, Huizhou First Hospital","place":["Huizhou,Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qili","family":"Chen","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingen","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huizhou First Hospital","place":["Huizhou,Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aizheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huizhou First Hospital","place":["Huizhou,Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yankun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huizhou First Hospital","place":["Huizhou,Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caiming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huizhou First Hospital","place":["Huizhou,Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2019.100338","article-title":"Overlapping demyelinating syndrome and anti- N-methyl-d-aspartate receptor encephalitis with seizures","volume":"12","author":"Taraschenko","year":"2019","journal-title":"Epilepsy Behav Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1093\/cei\/uxad109","article-title":"Myelin oligodendrocyte glycoprotein antibody and N-methyl-d-aspartate receptor antibody overlapping syndrome: insights from the recent case reports","volume":"215","author":"Du","year":"2024","journal-title":"Clin Exp Immunol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.2532","article-title":"Association between cytomegalovirus infection and neurological disorders: a systematic review","volume":"34","author":"Sanami","year":"2024","journal-title":"Rev Med Virol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000021238","article-title":"Anti-NMDA receptor encephalitis concomitant with myelin oligodendrocyte glycoprotein antibody diseases: a retrospective observational study","volume":"99","author":"Du","year":"2020","journal-title":"Med (Baltimore)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1007\/s00415-025-13011-5","article-title":"Clinical characterization of diseases associated with anti-N-methyl-d-aspartate receptor encephalitis combined with anti-myelin oligodendrocyte glycoprotein antibodies in adults","volume":"272","author":"Ding","year":"2025","journal-title":"J Neurol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-025-01292-5","article-title":"Investigation of anti- N-methyl-d-aspartate receptor and anti-myelin oligodendrocyte glycoprotein antibodies in patients with human herpesviruses-associated central nervous system infections","volume":"32","author":"Ishimaru","year":"2025","journal-title":"J Neurovirol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.769653","article-title":"Myelin oligodendrocyte glycoprotein antibody-associated disease and varicella zoster virus infection - frequency of an association","volume":"12","author":"Di Pauli","year":"2021","journal-title":"Front Immunol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30244-8","article-title":"Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis","volume":"17","author":"Armangue","year":"2018","journal-title":"Lancet Neurol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000458","article-title":"Anti-NMDA receptor encephalitis and nonencephalitic HSV-1 infection","volume":"5","author":"Salovin","year":"2018","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/v11080762","article-title":"Viruses and autoimmunity: A review on the potential interaction and molecular mechanisms","volume":"11","author":"Smatti","year":"2019","journal-title":"Viruses"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.47936\/encephalitis.2020.00066","article-title":"Anti-N-methyl-d-aspartate receptor encephalitis 8 years after serial herpes simplex virus type 1 and human herpesvirus type 7 encephalitis","volume":"1","author":"Jang","year":"2021","journal-title":"Encephalitis"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2016.08.292","article-title":"Anti-NMDA Receptor antibody encephalitis with concomitant detection of Varicella zoster virus","volume":"83","author":"Sol\u00eds","year":"2016","journal-title":"J Clin Virol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1664666","article-title":"Clinical features and prognosis of the adult patients positive for both N-methyl-d-aspartate receptor and myelin oligodendrocyte glycoprotein antibodies","volume":"16","author":"Ma","year":"2025","journal-title":"Front Immunol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1805851\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:43:46Z","timestamp":1780983826000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1805851\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,9]]},"references-count":13,"alternative-id":["10.3389\/fimmu.2026.1805851"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1805851","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,9]]},"article-number":"1805851"}}