Case Report
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World J Clin Cases. Apr 26, 2022; 10(12): 3951-3958
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3951
Recurrence of infectious mononucleosis in adults after remission for 3 years: A case report
Xin-Yue Zhang, Qi-Bei Teng
Xin-Yue Zhang, Department of Traditional Chinese Medicine, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou 310052, Zhejiang Province, China
Qi-Bei Teng, Department of Hematology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Author contributions: Zhang XY contributed to study design, data collection and analysis, statistical analysis, and manuscript drafting; Teng QB revised the manuscript; all authors have read and approved the manuscript.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Corresponding author: Xin-Yue Zhang, MM, Attending Doctor, Department of Traditional Chinese Medicine, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, No. 3333 Binsheng Road, Hangzhou 310052, Zhejiang Province, China. cicelyxyz@zju.edu.cn
Received: November 16, 2021
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Recurrence of IM after remission is possible in adults; therefore, long-term follow-up and monitoring are essential.

Keywords: Adults; Epstein–Barr virus; Infectious mononucleosis; Liver damage; Recurrence; Case report

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.