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Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue
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Published on: June 14, 2020

Massive retropharyngeal lymphadenopathy in an infant: an unusual presentation of infectious mononucleosis

Sudhir Lobo1, H Williams, V Singh

  • 1Department of Otolaryngology, Prince Charles Hospital, Merthyr Tydfil, East Glamorgan, UK. sudhirlobo@aol.com

The Journal of Laryngology and Otology
|January 26, 2005
PubMed

Insights

Epstein-Barr virus (EBV) infection is rare in infants, but can cause severe upper airway obstruction due to retropharyngeal lymph node swelling. Prompt medical intervention led to a full recovery in a six-month-old infant.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Otolaryngology

Background:

  • Infectious mononucleosis, typically caused by Epstein-Barr virus (EBV), commonly presents with tonsillar hypertrophy and lymphadenopathy causing upper airway obstruction in adolescents.
  • EBV infection in infants is uncommon, with limited documentation regarding its potential to cause significant airway compromise.

Observation:

  • A six-month-old infant presented with symptoms of an upper respiratory tract infection and mild upper airway obstruction.
  • Physical examination revealed massive enlargement of the retropharyngeal lymph nodes, significantly compromising the infant's airway.
  • Radiographic imaging confirmed the substantial retropharyngeal swelling and airway compromise.

Findings:

  • The infant was diagnosed with Epstein-Barr virus (EBV) infection, presenting atypically with severe retropharyngeal lymphadenopathy.
  • The condition led to significant upper airway obstruction, necessitating medical intervention.

Implications:

  • This case highlights that Epstein-Barr virus (EBV) can cause rare but life-threatening upper airway obstruction in young infants.
  • The retropharyngeal space is a potential site for airway obstruction in infants due to the presence of lymphoid tissue.
  • Early recognition and intervention, including surgical drainage and respiratory support, are crucial for managing such critical cases in infants.

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