Frauchiger B, Bonetti A, Vogt M, Streuli R
Schweiz Med Wochenschr. 1986 Apr 19;116(16):498-502.
The histological changes in cytomegalovirus (CMV) infection were first described by RIBBERT in 1881, and for years the virus was dreaded as the agent of infection in newborns. An infectious mononucleosis-like disease with negative heterophil antibodies in otherwise healthy adults was described in 1965. We present six previously healthy adults with CMV mononucleosis observed in 1984. The diagnosis was established by CMV-IgM-ELISA. All patients were febrile for an average of 20 days. The general state of health was reduced in three patients; one patient suffered from headache and another from abdominal pain. Physical examination showed splenomegaly and mild tonsillitis in one patient each, but in no case lymphadenopathy. All patients had lymhocytosis with reactive forms (virocytes). Elevation of transaminases was seen in four cases. Compared to Epstein-Barr virus mononucleosis, fever in CMV mononucleosis lasts significantly longer and lymphadenopathy is evidently rarer. The combination of fever of unknown origin, a negative heterophil antibody titer and the presence of virocytes prompts suspicion of CMV mononucleosis.
巨细胞病毒（CMV）感染的组织学变化最早由里贝特于1881年描述，多年来该病毒一直被视为新生儿感染的病原体而令人恐惧。1965年描述了一种在其他方面健康的成年人中出现的具有阴性嗜异性抗体的传染性单核细胞增多症样疾病。我们报告了1984年观察到的6例先前健康的患有CMV单核细胞增多症的成年人。诊断通过CMV-IgM-ELISA确定。所有患者发热平均持续20天。3例患者的总体健康状况下降；1例患者头痛，另1例患者腹痛。体格检查显示，各有1例患者出现脾肿大和轻度扁桃体炎，但均未出现淋巴结病。所有患者均有淋巴细胞增多及反应性形态（病毒细胞）。4例患者出现转氨酶升高。与EB病毒单核细胞增多症相比，CMV单核细胞增多症的发热持续时间明显更长，淋巴结病明显更少见。不明原因发热、嗜异性抗体滴度阴性和病毒细胞的存在提示怀疑为CMV单核细胞增多症。
