Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3951
Peer-review started: November 16, 2021
First decision: December 27, 2021
Revised: January 4, 2022
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 26, 2022
Processing time: 156 Days and 5.9 Hours
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.
Core Tip: Our case report demonstrates the possibility of infectious mononucleosis recurrence in cured adults after infection with Epstein–Barr virus (EBV). Because of the association between EBV infection and malignant diseases, long-term follow-up and monitoring are necessary.