EBV Infection: | Case 1 | Case 2 | Case 3 | Other Cases

Case 1 (by Yeung, Chap-Yung)

Patient: 31 month-old boy

Source: Hong Kong, 2001

Presenting features:
  Swinging and protracted fever for 26 days
  Treated for "throat infection", including several antibiotics
  No visible skin rash, some cervical lymph nodes +.

When assessed (on Day 26):
  Temp 39.5 C
  Generalised mildly enlarged lymph nodes ( neck, axillae, groins ) Firm spleen tip 2 cm, liver 1 1/2 cm

Relevant Investigations:
 
Hypochromic microcytic RBCs ( identified to be Thalassaemia-trait )
EBV titres: compatible with convalescence from recent infection -
 

Anti-bodies (IgG) to: EBNA-1p72+++, VCAp18++, VCAp23++, EAp138+, EAp54+

CMV negative

Diagnosis:
  Ebstein-Barr Virus Infection

Progress:
  symptoms subsided in 2 days with no active treatment

Lessons:
1)

Atypical Infectious Mononucleosis Syndrome ( not adolescent , no skin rash, tonsils and lymph node enlargement not particularly prominent )

2) Occurrence in early age - probably due to environmental, living or eating habits.

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