Zhang Xin-Yue, Teng Qi-Bei
Department of Traditional Chinese Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou 310052, Zhejiang Province, China.
Department of Hematology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China.
World J Clin Cases. 2022 Apr 26;10(12):3951-3958. doi: 10.12998/wjcc.v10.i12.3951.
Infectious mononucleosis (IM) is a disease caused by Epstein-Barr virus (EBV). EBV infection is common in children; however, it can cause IM in adults. Studies on recurrence of IM in adults after remission are limited.
We report a 28-year-old man who presented with IM-like symptoms with mild liver damage after initial remission of IM for 3 years. He was first diagnosed with IM and treated in 2015. Follow-up tests in 2016 and 2017 did not show any abnormalities. In November 2018, he presented with swelling of the tonsils. He was misdiagnosed with acute suppurative tonsillitis and treated for 5 d. No signs of improvement were observed. He was readmitted with recurrent fever, pharyngalgia, fatigue, and systemic muscle pain. Examinations revealed enlargement of the tonsils and cervical lymph nodes. Blood tests revealed elevated transaminase levels. Anti-EBV test was positive, indicating virus reactivation. IM recurrence was confirmed on the basis of laboratory tests and clinical manifestations. He was treated with antiviral, anti-infective, and hepatoprotective drugs and vitamin supplements. His condition improved and no abnormalities were observed during follow-up.
Recurrence of IM after remission is possible in adults; therefore, long-term follow-up and monitoring are essential.
传染性单核细胞增多症（IM）是由爱泼斯坦-巴尔病毒（EBV）引起的疾病。EBV感染在儿童中很常见；然而，它也可在成人中引起IM。关于成人IM缓解后复发的研究有限。
我们报告一名28岁男性，在IM初次缓解3年后出现类似IM的症状并伴有轻度肝损伤。他于2015年首次被诊断为IM并接受治疗。2016年和2017年的随访检查未发现任何异常。2018年11月，他出现扁桃体肿大。他被误诊为急性化脓性扁桃体炎并接受了5天治疗。未观察到改善迹象。他因反复发热、咽痛、乏力和全身肌肉疼痛再次入院。检查发现扁桃体和颈部淋巴结肿大。血液检查显示转氨酶水平升高。抗EBV检测呈阳性，表明病毒重新激活。根据实验室检查和临床表现确诊为IM复发。他接受了抗病毒、抗感染、保肝药物及维生素补充剂治疗。他的病情好转，随访期间未观察到异常。
成人IM缓解后可能复发；因此，长期随访和监测至关重要。
