Infectious mononucleosis secondary to Epstein-Barr virus typically follows a relatively benign and self-limited course. A small subset of individuals may develop further progression of disease including hematologic, neurologic, and cardiac abnormalities. A mild transient neutropenia occurring during the first weeks of acute infection is a common finding however in rare cases a more profound neutropenia and agranulocytosis may occur up to 6weeks following the onset of initial symptoms. We describe the case of an 18-year-old woman who presented 26days following an acute infectious mononucleosis diagnosis with agranulocytosis and fever. No source of infection was identified and the patient had rapid improvement in her symptoms and resolution of her neutropenia. The presence of fever recurrence and other non-specific symptoms in individuals 2-6weeks following acute infectious mononucleosis symptom onset may warrant further assessment for this uncommon event.
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http://dx.doi.org/10.1016/j.ajem.2016.11.042 | DOI Listing |
BMJ Case Rep
January 2025
Department of Rheumatology, US Department of Veterans Affairs, Fresno, California, USA.
Castleman's disease (CD), also called angiofollicular lymphoid hyperplasia, is a rare lymphoproliferative illness with two unique variants: unicentric disease and multicentric disease (MCD). The multicentric variant is rare and presents as a systemic illness with symptoms like peripheral lymphadenopathy, splenomegaly, anaemia and systemic inflammatory symptoms. Given the vague and systemic presentation, this variant can be difficult to differentiate from infection and other autoimmune diseases.
View Article and Find Full Text PDFCureus
December 2024
Department of Upper Gastrointestinal and Hepatobiliary Surgery, Monash Health, Melbourne, AUS.
Atraumatic splenic rupture (ASR) is a rare and life-threatening condition that presents diagnostic difficulties due to its rarity and non-specific clinical symptoms. It often requires computed tomography (CT) imaging for accurate diagnosis and surgical planning. Splenectomy is the standard treatment for unstable patients, but autotransplantation of splenic tissue may reduce the lifelong risks of overwhelming post-splenectomy infections (OPSI) by preserving some immunological function.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
Epstein-Barr virus (EBV) establishes persistent infection, causes infectious mononucleosis, is a major trigger for multiple sclerosis and contributes to multiple cancers. Yet, knowledge remains incomplete about how the virus remodels host B cells to support lytic replication. We previously identified that EBV lytic replication results in selective depletion of plasma membrane (PM) B cell receptor (BCR) complexes, composed of immunoglobulin and the CD79A and CD79B signaling chains.
View Article and Find Full Text PDFImmun Inflamm Dis
January 2025
Department of Pediatrics, NHO Okayama Medical Center, Okayama, Japan.
Aim: Kikuchi-Fujimoto disease (KFD) rarely affects pediatric patients and is characterized by prolonged fever and cervical lymphadenopathy. The diagnosis of KFD remains challenging and often requires an invasive biopsy. Low serum alkaline phosphatase levels have frequently been observed in patients with KFD; however, the clinical significance of low serum alkaline phosphatase levels remains unclear.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Guthrie Lourdes Hospital, Binghamton, USA.
Splenic infarction with infectious mononucleosis (IM) caused by Epstein-Barr Virus (EBV) has been reported as a rare complication of IM. The monospot test, often used to diagnose EBV-related IM, may produce false-negative results, especially in atypical presentations or early stages of infection. This report describes the case of a monospot-negative patient who developed splenic infarction as a complication of IM.
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