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[A case of severe thrombocytopenia in infectious mononucleosis].

The authors discuss a case of thrombocytopenia with bleeding occurred in a young woman with infectious mononucleosis admitted to the Infectious Disease Department of University of Catania. It is reported the pathogenetic hypothesis of virus-induced thrombocytopenia and therapy.

Acute Disease↗

Relationship of in vitro immune responses to Epstein-Barr herpesvirus and severity of infectious mononucleosis.

Immune responses to Epstein-Barr herpesvirus (EBV) and EBV-related antigens were studied serially in 18 patients with heterophil antibody-positive infectious mononucleosis and in 18 control subjects. Enhanced cellular immune responses to EBV particles and to EBV intracellular soluble antigens were found in the patients at convalescence, suggesting that the development of specific cellular immune responses was associated with apparent control of the virus infection. In addition, a correlation between severity of disease and specific cellular immune response was found. Patients with severe clinical signs were found to have a more active cellular immune response to EBV intracellular soluble antigens early in the infection compared with patients with mild disease. This suggests that an increased immune reactivity to intracellular antigens during the early part of the illness is related to the severity of clinical manifestations in infectious mononucleosis. Serum antibody to viral capsid antigen and early antigen was not related to the severity of clinical disease.

Antigens, Viral↗

Increased clearance of phenytoin as the presenting feature of infectious mononucleosis.

A 19-year-old man with posttraumatic seizures under good control with phenytoin, 500 mg/day, presented with three seizures. His blood level of phenytoin, previously in a therapeutic range, was 4.2 microgram/ml. No systemic or laboratory evidence of infectious mononucleosis was found. Ten days later, the blood picture became compatible with infectious mononucleosis, at which time his phenytoin clearance returned to normal.

Adult↗

Diffuse pneumonia and acute respiratory failure due to infectious mononucleosis in a middle-aged adult.

This report describes a 48-yr-old patient who developed bilateral hilar adenopathy, diffuse pulmonary infiltrates, and respiratory failure in association with infectious mononucleosis. Lung and paratracheal lymph node biopsies suggested the diagnosis, and an acute Epstein-Barr virus infection was confirmed serologically. Pulmonary involvement in infectious mononucleosis is reviewed, and atypical features, which may lead to diagnostic difficulty, particularly in the older adult, are discussed.

Acute Disease↗