Cases reported "Infectious Mononucleosis"

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1/25. infectious mononucleosis and bilateral peritonsillar abscesses resulting in airway obstruction.

    Upper airway obstruction is an uncommon but recognized complication of infectious mononucleosis. The management depends upon the degree of airway compromise. In the case described, severe airway obstruction was treated by securing the airway with awake fibre-optic endoscopic intubation and then proceeding to tonsillectomy. Bilateral inferiorly loculated quinsies were encountered unexpectedly and drained. This is the first report of 'bilateral' quinsies, associated with infectious mononucleosis and severe airway obstruction. The association, pathogenesis and significance of this finding are also discussed.
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keywords = airway obstruction, airway, obstruction
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2/25. intestinal pseudo-obstruction and acute pandysautonomia associated with Epstein-Barr virus infection.

    We report the association of neurological and intestinal disorders with the reactivation of Epstein-Barr virus (EBV) in a child. This previously healthy 13-yr-old boy presented with pharyngitis and acute abdominal ileus. laparotomy excluded a mechanical obstruction. Postoperatively, he suffered from prolonged intestinal obstruction, pandysautonomia, and encephalomyelitis. Histological examination of the appendix and a rectal biopsy taken 3 months after the onset showed an absence of ganglion cells (appendix) and hypoganglionosis (rectum), with a mononucleate inflammatory infiltrate in close contact with the myenteric neural plexuses. EBV-PCR was positive in the blood and cerebrospinal fluid, and in situ hybridization with the Epstein-Barr virus encoded rna probe showed positive cells throughout the appendix wall including the myenteric area, in a mesenteric lymph node, and in the gastric biopsies. EBV spontaneous lymphocytic proliferation was noted in the blood. The serology for EBV showed previous infection but anti-early antigen antibodies were present. No immunodeficiency was found. Neurological and GI recovery occurred after 6 months of parenteral nutrition and bethanechol. The omnipresence of EBV associated with the neurointestinal symptoms suggest that the virus was the causal agent. This is the first documented case of acquired hypoganglionnosis due to EBV reactivation.
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ranking = 0.016136431025917
keywords = obstruction
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3/25. Case report: an unusal cause of stridor in a post-liver transplant 6-year old.

    Polymorphic lymphoproliferative disorder is a recognised cause of upper airway obstruction in children [N. Sculerati, M. Arriga, Ann. Otol. Rhinol. Laryngol 99 (1990) 445-450]. It is associated with long-term immunosuppression therapy and frequently with Epstein-Barr virus (EBV) infection [D.W. Hanto, Annu. Rev. Med. 46 (1995) 381-394; B.D. Fletcher, H.E. Heslop, H.C. Kaste, S. Bodner, Upper airway obstruction and pulmonary abnormalities due to lymphoproliferative disease following bone marrow transplantation in children, Pediatr. Radiol. 28 (1998) 492-496]. The prevalence in reported series ranges from 4 to 13% among post-transplant children [M. Ho, R. Jaffe, G. Miller, Transplantation 45 (1988) 719-727; G.B. Hammer, S. Cao, M.G. Boltz, A. Messner, anesthesiology 89 (1998) 263-265; B.V. Lattyak, P. Rosenthal, Post-transplant lymphoproliferative disorder presenting in the head and neck, Laryngoscope 108 (1998) 1195-1198]. This condition may present in the transplanted allograft, the gastrointestinal tract, the head and neck, and in particular in the upper airway. Previously reported cases of upper airway obstruction have been in the supraglottis, Waldeyer's ring, the glottis, and one case of an intra tracheal mass [M. Ho, R. Jaffe, G. Miller, Transplantation 45 (1988) 719-727; G.B. Hammer, S. Cao, M.G. Boltz, A. Messner, anesthesiology 89 (1998) 263-265]. We report a case of post-transplant lymphoproliferative disorder in the sub-glottis causing acute upper airway obstruction with negative (EBV) serology.
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ranking = 0.57097260096388
keywords = airway obstruction, airway, obstruction
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4/25. Unexpected death due to infectious mononucleosis.

    A 14-year-old boy with infectious mononucleosis died unexpectedly in hospital. The most significant finding at autopsy was the presence of marked bilateral tonsillar enlargement with considerable narrowing of the upper airway. There were no other underlying organic diseases that could have caused or contributed to death. Narcotic analgesia had been administered less than 2 h before death and may have contributed to respiratory compromise. The blood morphine level was 0.08 mg/L. Toxicological evaluation of individuals with obstructive lesions of the upper airway may, therefore, be a useful adjunct to the autopsy assessment of such cases as it may reveal factors exacerbating mechanical blockage.
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ranking = 0.0063835865056475
keywords = airway
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5/25. Treatment of severe infectious mononucleosis with famciclovir.

    We report a patient with severe acute infectious mononucleosis who was successfully treated with famciclovir. A 15-year-old male was admitted with a 6-week history of fever, malaise, generalized lymphadenopathy, and hepatosplenomegaly, the patient was acutely ill with a temperature of 39.0 degrees C. Oropharingeal examination revealed enlarged tonsils partially obstructing the airways. EBV serology obtained during admission showed a positive Monospot test, virus capsid antigen IgM, 1:320, Epstein-Barr nuclear and early antigen, negative. After 72 hours of treatment with famciclovir (500 mg t.i.d.), the patient was afebrile with important regression of the lymphadenopathy, enlarged tonsils and hepatosplenomegaly. Because acute infectious mononucleosis may be associated with extensive and prolonged disease, the potential therapeutic role of famciclovir in the treatment of severe forms of the disease deserves further studies.
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ranking = 0.0031917932528237
keywords = airway
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6/25. Florid infectious mononucleosis: clinicopathological correlation in acute tonsillectomy.

    In patients with infectious mononucleosis (IM), acute tonsillectomy is advocated only in the minority who develop severe airway compromise. In such florid cases, the pathological diagnosis of IM, well known to morphologically simulate that of lymphoma, is particularly challenging. The present case describes a 15-year old male with a clinical course consistent with IM in whom acute tonsillectomy was performed due to progressive airway obstruction. The striking histological findings emphasize the need for close clinicopathological correlation. Recently available ancillary studies are described which both surgeon and pathologist should be familiar with in the differentiation of IM from other lymphoproliferative conditions.
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ranking = 0.14513699518059
keywords = airway obstruction, airway, obstruction
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7/25. infectious mononucleosis presenting as upper airway obstruction.

    Upper airway obstruction though a common complication of infectious mononucleosis is rarely considered in differential diagnosis of stridor. We report a three-year-old child who had upper airway obstruction due to infectious mononucleosis, managed conservatively with oxygen, intravenous fluids and steroids.
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ranking = 0.85167121156659
keywords = airway obstruction, airway, obstruction
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8/25. infectious mononucleosis.

    BACKGROUND: infectious mononucleosis is caused by the ubiquitous Epstein-Barr virus. It is a common condition usually affecting adolescents and young adults. Most cases are mild to moderate in severity with full recovery taking place over several weeks. More severe cases and unusual complications occasionally occur. OBJECTIVE: After presenting a case of severe infectious mononucleosis, the spectrum of disease is given. diagnosis and complications are reviewed as well as management including the possible role for antiviral medications or corticosteroid therapy. DISCUSSION: The majority of cases of infectious mononucleosis are self limiting and require only supportive care. More severe cases, although unusual, may require admission to hospital and even to an intensive care unit. Corticosteroid therapy may be indicated for severe airway obstruction or other severe complications, but should be avoided unless the benefits outweigh potential risks. Antiviral therapy has no proven benefit.
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ranking = 0.14194520192776
keywords = airway obstruction, airway, obstruction
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9/25. Massive retropharyngeal lymphadenopathy in an infant: an unusual presentation of infectious mononucleosis.

    infectious mononucleosis causing upper airway obstruction due to tonsillar disease and associated lymphadenopathy in adolescents is well recognized. However, infection with Epstein-Barr virus (EBV) in a young child of six months is rare. The authors present such a case, with massive swelling of the retropharyngeal lymph nodes, that has not been published previously. The patient presented to this department with a short history of an upper respiratory tract infection and mild upper airway obstruction. On examination there was a massive enlargement of the retropharyngeal space with a compromised airway. This was confirmed on X-ray. She made an uneventful recovery following incision and drainage and a short period of endotracheal intubation. Because of the presence of retropharyngeal lymphoid tissue in infancy an alternative site of upper airway obstruction may occur here in this age group.
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ranking = 0.42902739903612
keywords = airway obstruction, airway, obstruction
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10/25. 1. Fatal acute hepatitis in infectious mononucleosis in a forensic setting: a case report.

    Mononucleosis is generally considered a benign, self-limited disease. However, though uncommon, fatal complications are sometimes encountered. Deaths from liver failure, splenic rupture, respiratory obstruction, neurological complications, secondary infections and bleeding complications have been described. In the forensic setting, there are a few reports of sudden and unexplained deaths from splenic rupture and upper airway obstruction. We report here the first case of sudden and unexplained death from acute hepatitis in infectious mononucleosis presenting as a suspicious death.
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ranking = 0.14463460709875
keywords = airway obstruction, airway, obstruction
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