Spontaneous Regression of Pulmonary Nodules Presenting as Epstein-Barr Virus-related Atypical Infectious Mononucleosis

Shinozuka, Jun; Awaguni, Hitoshi; Tanaka, Shinichiro; Makino, Seiya; Maruyama, Rikken; Inaba, Tohru; Imashuku, Shinsaku

doi:10.1097/mph.0000000000000562

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…Very few cases have been reported in the literature regarding the use of PET/CT during mononucleosis infection [9] , [10] , [11] , [12] . Mathilde Ørbæk et al described a 21-year-old man with infectious mononucleosis who underwent PET/CT due to concern of malignant lymphoma, showing pathologically increased 18 F-FDG uptake in scattered lymph nodes and spleen [9] .…”

Section: Discussionmentioning

confidence: 99%

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Two cases of misleading Epstein-Barr virus infection and the role of EBV-DNA

Pipitò,

Murabito,

Cascio

2024

IDCases

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Section: Discussionmentioning

confidence: 99%

“…In Japan, a case of atypical infectious mononucleosis with pulmonary involvement was reported in a 12-year-old boy, characterized by high signal intensity at the pulmonary hilar nodules and both pharyngeal tonsils on a PET scan [12] .…”

Section: Discussionmentioning

confidence: 99%

Two cases of misleading Epstein-Barr virus infection and the role of EBV-DNA

Pipitò,

Murabito,

Cascio

2024

IDCases

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“…Pelliccia, et al [2] described a 14-year-old girl with EBV positive IMN with multiple pulmonary nodules as well as mild pericardial effusion and hydrops of gall bladder, all of which resolved on follow up . Shinozuka, et al [3] described a case of multiple lung nodules in an adolescent with IMN which spontaneously regressed over a two year period.…”

Section: Discussionmentioning

confidence: 99%

Multiple Pulmonary Nodules in an Immunocompetent Adolescent with Infectious Mononucleosis

et al. 2018

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Background Infectious mononucleosis is usually a self-limiting illness, but can be rarely associated with complications. Case characteristics A 17-year-old boy with Epstein-Barr virus related infectious mononucleosis and cold antibody-mediated autoimmune hemolytic anemia with incidentally noted multiple pulmonary nodules. Observations Nodules regressed over the next few weeks without specific therapy. Message Pediatricians need to be aware of this rare clinical presentation of infectious mononucleosis so that further invasive testing can be avoided.

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Infectious Mononucleosis: An Updated Review

Leung

Lam

Barankin³

2024

CPR

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Background: Infectious mononucleosis is common among adolescents and young adults. Although the majority of cases resolve spontaneously, life-threatening manifestations, and complications have been recognised. Objective: The purpose of this article is to familiarize clinicians with the clinical manifestations, evaluation, diagnosis, and management of infectious mononucleosis. Methods: A search was conducted in October 2022 in PubMed Clinical Queries using the key terms "infectious mononucleosis" OR “Epstein-Barr virus” OR “EBV”. The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the aforementioned search was used in the compilation of the present article. Results: Infectious mononucleosis, caused by Epstein-Barr virus, most commonly affects adolescents and adults aged 15 to 24 years. Epstein-Barr virus is transmitted primarily in saliva. Infectious mononucleosis is characterized by a triad of fever, tonsillar pharyngitis, and lymphadenopathy. Fatigue may be profound but tends to resolve within three months. Periorbital and/or palpebral edema, typically bilateral, occurs in one-third of patients. Splenomegaly and hepatomegaly occur in approximately 50% and 10% of cases, respectively. A skin rash, which is usually widely scattered, erythematous, and maculopapular, occurs in approximately 10 to 45% of cases. Peripheral blood leukocytosis is observed in most patients; lymphocytes make up at least 50% of the white blood cell differential count. Atypical lymphocytes constitute more than 10% of the total lymphocyte count. The classic test for infectious mononucleosis is the demonstration of heterophile antibodies. The monospot test is the most widely used method to detect the serum heterophile antibodies of infectious mononucleosis. When confirmation of the diagnosis of infectious mononucleosis is required in patients with mononucleosis-like illness and a negative mono-spot test, serologic testing for antibodies to viral capsid antigens is recommended. Infectious mononucleosis is a risk factor for chronic fatigue syndrome. Spontaneous splenic rupture occurs in 0.1 to 0.5% of patients with infectious mononucleosis and is potentially life-threatening. Treatment is mainly supportive. Reduction of activity and bed rest as tolerated are recommended. Patients should be advised to avoid contact sports or strenuous exercise for 8 weeks or while splenomegaly is still present. Most patients have an uneventful recovery. Conclusion: Infectious mononucleosis is generally a benign and self-limited disease. Prompt diagnosis is essential to avoid unnecessary investigations and treatments and to minimize complications. Splenic rupture is the most feared complication. As avoiding exposure to EBV is almost impossible, the most effective way to prevent EBV infection and infectious mononucleosis is the development of an effective, safe, and affordable EBV vaccine that can confer life-long immunity.

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Spontaneous Regression of Pulmonary Nodules Presenting as Epstein-Barr Virus-related Atypical Infectious Mononucleosis

Abstract: Differential diagnosis of pulmonary nodules in childhood should include atypical EBV infection.

Cited by 3 publications

References 20 publications

Two cases of misleading Epstein-Barr virus infection and the role of EBV-DNA

Two cases of misleading Epstein-Barr virus infection and the role of EBV-DNA

Multiple Pulmonary Nodules in an Immunocompetent Adolescent with Infectious Mononucleosis

Infectious Mononucleosis: An Updated Review

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