Related Experiment Videos
[Infections mononucleosis with pleural effusion]
Y Takakura1, Y Kobayashi, Y Takahashi
1First department of internal medicine, Kyoto Prefectural University of Medicine.
Summary
Pleural effusion, a rare infectious mononucleosis complication, stems from T-lymphocyte infiltration in the pleura. This study details a case of Epstein-Barr virus infection causing T-cell mediated pleuritis.
Area of Science:
- Infectious Diseases
- Immunology
- Pulmonology
Background:
- Infectious mononucleosis (IM) is a common viral illness, typically self-limiting.
- Pleural effusion is a rare manifestation of IM, with its pathogenesis not fully elucidated.
- Primary Epstein-Barr virus (EBV) infection can present with diverse clinical symptoms.
Observation:
- A 24-year-old male presented with fever, pharyngitis, hepatosplenomegaly, and pleural effusion.
- Laboratory tests revealed elevated liver enzymes and positive EBV-specific antibodies, confirming primary EBV infection.
- Analysis of peripheral blood and pleural effusion showed a decreased CD4/CD8 T-cell ratio and mononuclear cell infiltration.
Findings:
- Pleural fluid analysis indicated an exudative effusion with mononuclear cell predominance.
- Pleural biopsy confirmed perivascular T-lymphocyte infiltration, predominantly CD3+ T-cells (approximately 90%).
- The decreased CD4/CD8 ratio in both blood and effusion suggests a role for T-cell dysregulation in EBV-associated pleural effusion.
Implications:
- The findings suggest T-lymphocyte infiltration is the primary mechanism driving pleural effusion in infectious mononucleosis.
- This case highlights the importance of considering EBV infection in young adults presenting with unexplained pleural effusions.
- Further research into the immunopathogenesis of EBV-related pleural complications is warranted.