Recurrence of infectious mononucleosis in adults after remission for 3 years: A case report

Area of Science:

• Infectious Diseases
• Virology
• Immunology

Background:

• Infectious mononucleosis (IM), a common childhood illness caused by Epstein-Barr virus (EBV), can manifest in adults.
• Limited research exists on the recurrence of IM in adults following initial remission.
• EBV is a ubiquitous herpesvirus with a significant impact on adult health.

Observation:

• A 28-year-old male experienced IM-like symptoms, including tonsil swelling and mild liver damage, three years after his initial IM diagnosis and remission.
• Initial misdiagnosis as acute suppurative tonsillitis delayed appropriate treatment.
• Recurrent symptoms included fever, pharyngalgia, fatigue, muscle pain, enlarged tonsils and lymph nodes, and elevated transaminases, indicating EBV reactivation.

Findings:

• Laboratory tests confirmed EBV reactivation and IM recurrence.
• The patient's condition improved with a treatment regimen including antiviral, anti-infective, hepatoprotective drugs, and vitamin supplements.
• This case demonstrates a rare instance of IM recurrence in an adult after a prolonged period of remission.

Implications:

• Adults who have had IM require long-term follow-up and monitoring for potential EBV reactivation.
• Clinicians should consider IM recurrence in adults presenting with persistent IM-like symptoms, even years after initial diagnosis.
• Understanding EBV latency and reactivation is crucial for managing adult infectious mononucleosis.