Infectious Mononucleosis Resulting in Acute Necrotizing Mediastinitis: A Case Report and Literature Review.
Epstein-Barr virus
descending necrotizing mediastinitis
infectious mononucleosis
reactive hemophagocytic syndrome
retropharyngeal abscess
Journal
European journal of case reports in internal medicine
ISSN: 2284-2594
Titre abrégé: Eur J Case Rep Intern Med
Pays: Italy
ID NLM: 101648453
Informations de publication
Date de publication:
2020
2020
Historique:
received:
21
06
2020
accepted:
24
06
2020
entrez:
16
11
2020
pubmed:
17
11
2020
medline:
17
11
2020
Statut:
epublish
Résumé
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. 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.
Identifiants
pubmed: 33194856
doi: 10.12890/2020_001829
pii: 1829-1-15792-2-10-20200813
pmc: PMC7654993
doi:
Types de publication
Journal Article
Langues
eng
Pagination
001829Informations de copyright
© EFIM 2020.
Déclaration de conflit d'intérêts
Conflicts of Interests: The Authors declare that there are no competing interests.
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