Chaprava Tamari, Ostatishvili Khatia, Kirtadze Nana, Goginava Alexandre, Tabatadze Irakli
Infectious Diseases, Pineo Medical Ecosystem, Tbilisi, GEO.
Department of Microbiology, Tbilisi State Medical University, Tbilisi, GEO.
Cureus. 2025 Jul 29;17(7):e89023. doi: 10.7759/cureus.89023. eCollection 2025 Jul.
Infectious mononucleosis (IM), caused by the Epstein-Barr virus (EBV), is primarily a self-limiting illness. However, it often mimics bacterial infections, such as bacterial tonsillitis, which can represent a diagnostic pitfall and, consequently, increase the risk of developing complications. The aim of this case report is to highlight the complications resulting from the incorrect differential diagnosis of EBV-induced IM and its clinical significance. We present the case of a 24-year-old male who was initially misdiagnosed with bacterial tonsillitis. Amoxicillin-clavulanic acid was initiated for treatment, after which he developed a widespread maculopapular rash. Acute EBV infection was diagnosed via serological tests. His condition improved following the discontinuation of antibiotic therapy and the administration of supportive symptomatic treatment. This case underscores the critical need for careful differential diagnosis between viral and bacterial tonsillitis. It demonstrates that an amoxicillin-clavulanic acid-induced rash can serve as an important clue for underlying EBV infection, thereby preventing unnecessary antibiotic use and enabling the correct direction of investigation and management.
传染性单核细胞增多症（IM）由爱泼斯坦-巴尔病毒（EBV）引起，主要是一种自限性疾病。然而，它常常模仿细菌感染，如细菌性扁桃体炎，这可能导致诊断失误，进而增加发生并发症的风险。本病例报告的目的是强调因对EBV诱导的IM进行错误鉴别诊断而导致的并发症及其临床意义。我们报告一例24岁男性病例，该患者最初被误诊为细菌性扁桃体炎。开始使用阿莫西林-克拉维酸进行治疗，之后他出现了广泛的斑丘疹。通过血清学检测诊断为急性EBV感染。停用抗生素治疗并给予支持性对症治疗后，他的病情有所改善。该病例强调了对病毒性和细菌性扁桃体炎进行仔细鉴别诊断的迫切需要。它表明阿莫西林-克拉维酸引起的皮疹可作为潜在EBV感染的重要线索，从而避免不必要的抗生素使用，并为正确的检查和管理指明方向。
