Infectious Mononucleosis Resulting in Acute Necrotizing Mediastinitis: A Case Report and Literature Review
| Autor: | Samuel Markowicz, Soraya Cherifi, Serge Cappeliez, Héloïse Van Noten |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty Mononucleosis business.industry Incidence (epidemiology) lcsh:R 030106 microbiology lcsh:Medicine Retropharyngeal abscess Articles medicine.disease medicine.disease_cause Mediastinitis Epstein–Barr virus Empyema 03 medical and health sciences 0302 clinical medicine Internal Medicine Medicine 030212 general & internal medicine Reactive Hemophagocytic Syndrome business Abscess |
| Zdroj: | European Journal of Case Reports in Internal Medicine (2020) Eur J Case Rep Intern Med |
| ISSN: | 2284-2594 |
| Popis: | The serological prevalence of Epstein-Barr virus (EBV) among young adults exceeds 90% worldwide. Even though EBV primary infection is usually benign, severe complications can occur in adolescents and young adults and so the disease must be promptly diagnosed. The development of an oropharyngeal abscess leading to a descending necrotizing mediastinitis (DNM) is exceptional and potentially lethal, so early diagnosis with a CT scan, appropriate antibiotics and surgery are essential. The authors present a case where DNM was associated with reactive hemophagocytic syndrome as a result of infectious mononucleosis, as well as a review of similar cases in the English literature. LEARNING POINTS: The incidence of serious complications in Epstein-Barr virus (EBV) primary infection increases with age. Respiratory symptoms (e.g., pleuritic pain, dyspnoea) and unusually prolonged fever (>10 days) in patients with infectious mononucleosis could be ‘red flags’ for life-threatening complications such as empyema and descending necrotizing mediastinitis. The threshold for performing cervical and chest computed tomography in septic patients with infectious mononucleosis should be low. |
| Databáze: | OpenAIRE |
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