Zawar Vijay, Chuh Antonio, Sankalecha Sudhir
Department of Dermatology, Skin Diseases Center, Nashik, India.
J Dermatol Case Rep. 2009 Nov 28;3(3):44-6. doi: 10.3315/jdcr.2009.1035.
The rash in infectious mononucleosis is usually diffusely macular.
A 15-year-old boy presented to us with high grade fever, sore throat, malaise, body aches, and polyarthralgia. He developed annular, erythematous, and non-scaly eruptions on chest and right arm. Blanching erythema was noted on his trunk. He had bilateral tender cervical lymph nodes, severe pharyngeal congestion, petechiae on soft palate, uvular edema, infraorbital edema, and marginal tender hepatomegaly. Investigations revealed lymphocytosis and activated atypical lymphocytes in the peripheral smear, and positive monospot test. The boy subsequently recovered in one week with total disappearance of his rash. Epstein-Barr virus-related infectious mononucleosis was considered the most likely diagnosis for our patient.
To our knowledge, this atypical case is the third reported case of annular lesions in infectious mononucleosis. Dermatologists and other clinicians should be alerted to this special presentation of primary EBV infection.
传染性单核细胞增多症的皮疹通常为弥漫性斑疹。
一名15岁男孩前来就诊，伴有高热、咽痛、乏力、全身酸痛和多关节痛。他胸部和右臂出现环状、红斑性且无鳞屑的皮疹。其躯干可见压之褪色的红斑。他双侧颈部淋巴结压痛，咽部严重充血，软腭有瘀点，悬雍垂水肿，眶下水肿，肝脏边缘压痛肿大。检查发现外周血涂片有淋巴细胞增多和活化的异型淋巴细胞，嗜异性凝集试验阳性。该男孩随后在一周内康复，皮疹完全消失。爱泼斯坦 - 巴尔病毒相关的传染性单核细胞增多症被认为是该患者最可能的诊断。
据我们所知，这一非典型病例是传染性单核细胞增多症中环状损害的第三例报道。皮肤科医生和其他临床医生应警惕原发性EB病毒感染的这种特殊表现。
