{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:41:32Z","timestamp":1760125292999,"version":"build-2065373602"},"reference-count":11,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T00:00:00Z","timestamp":1679788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Background: We describe a case of EBV aseptic meningitis in a patient with HIV with an extensive history of prior infections and exposures. Detailed Case Description: A 35-year-old man with a history of HIV, syphilis, and partially treated tuberculosis presented with headache, fever, and myalgias. He reported recent exposure to dust from a construction site and had sexual contact with a partner with active genital lesions. An initial workup revealed mildly elevated inflammatory markers, significant pulmonary scarring from tuberculosis with a classic \u201cweeping willow sign\u201d, and lumbar puncture findings consistent with aseptic meningitis. An extensive evaluation was conducted to identify causes of bacterial and viral meningitis, including syphilis. Immune reconstitution inflammatory syndrome and isoniazid-induced aseptic meningitis were also considered based on his medications. EBV was ultimately isolated through PCR from the patient\u2019s peripheral blood. The patient\u2019s condition improved, and he was discharged on his home antiretroviral and anti-tuberculous treatment. Conclusion: Central nervous system infections represent unique challenges in patients with HIV. EBV reactivation can present with atypical symptoms and should be considered as a cause of aseptic meningitis in this population.<\/jats:p>","DOI":"10.3390\/tropicalmed8040191","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T02:18:27Z","timestamp":1679883507000},"page":"191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Headache, Fever, and Myalgias in an HIV-Positive Male with a History of Tuberculosis: Epstein\u2013Barr Virus Aseptic Meningitis"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6245-1569","authenticated-orcid":false,"given":"Loukas","family":"Kakoullis","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA"},{"name":"Harvard Medical School, Boston, MA 02138, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Hentschel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA"},{"name":"Harvard Medical School, Boston, MA 02138, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Colgrove","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA 02138, USA"},{"name":"Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA 02138, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1038\/nrneurol.2016.149","article-title":"HIV-Associated Opportunistic CNS Infections: Pathophysiology, Diagnosis and Treatment","volume":"12","author":"Bowen","year":"2016","journal-title":"Nat. Rev. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Martelius, T., Lappalainen, M., Palom\u00e4ki, M., and Anttila, V.J. (2011). Clinical Characteristics of Patients with Epstein Barr Virus in Cerebrospinal Fluid. BMC Infect. Dis., 11.","DOI":"10.1186\/1471-2334-11-281"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/B978-0-444-63849-6.00014-1","article-title":"Primary CNS Lymphoma in HIV Infection","volume":"152","author":"Brandsma","year":"2018","journal-title":"Handb. Clin. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Pyrgos, V., Seitz, A.E., Steiner, C.A., Prevots, D.R., and Williamson, P.R. (2013). Epidemiology of Cryptococcal Meningitis in the US: 1997\u20132009. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0056269"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S1474-4422(12)70098-4","article-title":"HIV-Associated Opportunistic Infections of the CNS","volume":"11","author":"McArthur","year":"2012","journal-title":"Rev. Lancet Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s00281-015-0532-2","article-title":"HIV-1 Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome","volume":"38","author":"Lai","year":"2016","journal-title":"Semin. Immunopathol."},{"key":"ref_7","unstructured":"Orient, J. (2019). Sapira\u2019s Art & Science of Bedside Diagnosis, Lippincott Williams & Wilkins."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"158","DOI":"10.4103\/1817-1737.160831","article-title":"Auscultation of the Respiratory System","volume":"10","author":"Sarkar","year":"2015","journal-title":"Ann. Thorac. 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Dis."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/8\/4\/191\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:03:32Z","timestamp":1760123012000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/8\/4\/191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,26]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["tropicalmed8040191"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed8040191","relation":{},"ISSN":["2414-6366"],"issn-type":[{"type":"electronic","value":"2414-6366"}],"subject":[],"published":{"date-parts":[[2023,3,26]]}}}