Epstein-Barr Virus-Induced Polymorphic Nodal Lymphoproliferative Disorder Presenting as Recurrent Fever and Scrotal Swelling: A Case Report and Review of Literature

Abstract

Epstein-Barr virus (EBV) has been associated with the development of lymphoproliferative disorders (LPDs). Adults rarely develop systemic EBV-positive LPDs. We report a case of EBV-associated LPD presenting as recurrent scrotal swelling and fever for over nearly 30 years in an immunocompetent adult. A 64-year-old Caucasian male presented with generalized weakness, myalgia and fever associated with scrotal swelling and bilateral groin pain. He reported that these symptoms have recurred yearly for the past 30 years, lasting 1 - 2 days each. Systemic examination was normal except genital exam positive for scrotal swelling without tenderness and bilateral tender inguinal lymphadenopathy. Computed tomography (CT) scan of chest, abdomen and pelvis showed bilateral lymphadenopathy along external iliac chains and groins. Histopathological examination showed EBV-associated LPD and patient was started on rituximab. EBV is known to persist as a lifelong low-level infection in memory B cells of normal healthy carriers. Our patients disease course over three decades is likely secondary to this property, in the setting of an intact immune system.




J Med Cases. 2016;7(8):354-357
doi: https://doi.org/10.14740/jmc2579w