Multiorgan Failure Associated with Epstein-Barr Viremia-An Elusive Diagnosis: A Case Series

Fulminant Epstein Barr Virus (EBV), also known as (herpes simplex virus-4(HSV-4) induced multiple organ failure is rarely reported and should be considered a potential diagnosis in patients with multiple organ failure. From a clinical perspective, it should be remembered that fulminant herpes simplex Virus (HSV) infection may masquerade as “routine” bacterial severe sepsis/septic shock. This potentially fatal condition should be diagnosed early and treated. Here we describe three cases who were admitted with multi organ dysfunction and two of them finally deceasing in a septic shock with multi organ failure. No bacterial or fungal infection could be detected in one of these cases and were adequately treated in other two cases. The presence of EBV (HSV-4) was detected in plasma confirming EBV viremia. The presentation, clinical course and management are discussed.