Massoll Anthony F, Powers Stanlyn C, Betten David P
Michigan State University College of Human Medicine, East Lansing, MI, United States.
Section of Emergency Medicine, Department of Internal Medicine, Michigan State University College of Osteopathic Medicine, Sparrow Health System, Lansing, MI, United States.
Am J Emerg Med. 2017 May;35(5):803.e5-803.e6. doi: 10.1016/j.ajem.2016.11.042. Epub 2016 Nov 19.
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.
由爱泼斯坦-巴尔病毒引起的传染性单核细胞增多症通常病程相对良性且自限。一小部分个体可能会出现疾病的进一步进展,包括血液学、神经系统和心脏异常。急性感染最初几周出现的轻度短暂性中性粒细胞减少是常见表现,然而在罕见情况下,初始症状出现后长达6周可能会发生更严重的中性粒细胞减少和粒细胞缺乏症。我们描述了一名18岁女性的病例,她在急性传染性单核细胞增多症诊断后26天出现粒细胞缺乏症和发热。未发现感染源,患者症状迅速改善,中性粒细胞减少症得到缓解。急性传染性单核细胞增多症症状出现后2至6周出现发热复发和其他非特异性症状的个体,可能需要对这一罕见事件进行进一步评估。