J Korean Med Sci.  2010 Feb;25(2):321-323. 10.3346/jkms.2010.25.2.321.

A Case of Hypersensitivity to Mosquito Bite Associated with Epstein-Barr Viral Infection and Natural Killer Cell Lymphocytosis

• Roh EJ
• Chung EH
• Chang YP
• Myoung NH
• Jee YK
• Seo M
• Kang JH

• KMID: 1779269
• DOI: http://doi.org/10.3346/jkms.2010.25.2.321

Abstract

Hypersensitivity to mosquito bites (HMB) is a disorder characterized by a necrotic skin reaction and generalized symptoms subsequent to mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer cell leukemia/lymphoma. We describe here a Korean child who had HMB associated with chronic EBV infection and natural killer cell lymphocytosis. A 5-yr-old boy was suffered from necrotic skin lesions on the right ear lobe. Type A EB virus was detected from hlood cells and bone marrow biospy recognized hemophagocyrosis.

Keyword

Hypersensitivity; Culicidae; Epstein-Barr Virus Infections; Killer Cells, Natural; Lymphocytosis

MeSH Terms

Animals
Child, Preschool
Culicidae/*immunology
Epstein-Barr Virus Infections/complications/*diagnosis
Herpesvirus 4, Human/genetics/isolation & purification
Humans
Hypersensitivity/complications/*diagnosis
Insect Bites and Stings/complications/*immunology
Killer Cells, Natural/immunology/*pathology
Lymphocytosis/complications/*diagnosis
Male
Polymerase Chain Reaction

Figure

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  Fig. 1 (A) The skin lesion that developed after mosquito bites on the right ear. (B) Necrotic change of the lesion on the right ear on the sixth hospital day.

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  Fig. 2 (A) The skin patch test for the mosquito allergens Lt, Aedes togoi; Rt, Culex pipiens. (B) The skin patch test shows a positive reaction to Culex pipiens (Rt) and a negative reaction to Aedes togoi (Lt).

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  Fig. 3 Polymerase chain reaction of EB virus in blood mononuclear cell. B, positive control; A, EB virus.

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  Fig. 4 Imunostaining for the CD56 antigen, a NK-cell marker, reveals many immunoreactive cells, suggesting the presence of NK cells (brown color) within the perivascular inflammatory infiltrates.

Reference

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