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Pseudoappendicitis preceding infectious mononucleosis
P M Adcock1, H S Nagaraj, G S Marshall
1Department of Pediatrics, University of Louisville School of Medicine, Kentucky, USA.
Abstract:
In patients with infectious mononucleosis, abdominal pain is usually attributed to visceral enlargement. A teenage girl with symptoms of appendicitis was found at laparotomy to have mesenteric adenitis. Postoperatively, she developed classic features of Epstein-Barr virus (EBV)-induced mononucleosis. The lymphoproliferation characteristic of EBV infection can cause severe localized abdominal pain that predates the onset of mononucleosis.
Insights
Abdominal pain in infectious mononucleosis can mimic appendicitis. Epstein-Barr virus (EBV) lymphoproliferation can cause localized pain before mononucleosis symptoms appear.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Virology
Background:
- Abdominal pain in infectious mononucleosis is often linked to organ enlargement.
- Mesenteric adenitis is a common cause of abdominal pain in children and adolescents.
Observation:
- A teenage girl presented with appendicitis-like symptoms.
- Laparotomy revealed mesenteric adenitis, not appendicitis.
- She later developed classic Epstein-Barr virus (EBV)-induced mononucleosis.
Findings:
- EBV infection can cause significant lymphoproliferation.
- This lymphoproliferation can lead to severe, localized abdominal pain.
- The abdominal pain may precede other symptoms of mononucleosis.
Implications:
- EBV infection should be considered in the differential diagnosis of acute abdominal pain in adolescents.
- Localized lymphoproliferation can manifest as severe abdominal pain, mimicking surgical emergencies.
- Early recognition of EBV-associated abdominal pain may prevent unnecessary surgical interventions.