Axelrod P, Finestone A J
Temple University School of Medicine and Hospital, Philadelphia, Pennsylvania.
Am Fam Physician. 1990 Dec;42(6):1599-606.
Infectious mononucleosis as a manifestation of primary Epstein-Barr virus infection occurs uncommonly in adults over age 40. While fever is almost universal, older patients with the disease often present without lymphadenopathy, pharyngitis, splenomegaly, lymphocytosis or atypical lymphocytes. Jaundice and hepatomegaly occur more commonly in older patients than in adolescents and create diagnostic confusion. Often, infectious mononucleosis in this age group is confused with lymphoma, leukemia or biliary obstruction, or is classified as "fever of unknown origin."
传染性单核细胞增多症作为原发性爱泼斯坦-巴尔病毒感染的一种表现，在40岁以上的成年人中并不常见。虽然发热几乎是普遍症状，但患有该病的老年患者通常没有淋巴结病、咽炎、脾肿大、淋巴细胞增多或异型淋巴细胞。黄疸和肝肿大在老年患者中比在青少年中更常见，这会造成诊断上的混淆。通常，这个年龄组的传染性单核细胞增多症会与淋巴瘤、白血病或胆道梗阻相混淆，或者被归类为“不明原因发热”。
