Fatal Infectious Mononucleosis: A case report.

Lee, Seung Ah; Yim, Hyun Ee; You, Young Yul; Kim, Jang Hee

Case Report

Korean Journal of Legal Medicine 2007;31(2):188-191.
Published online November 30, 2007.

Fatal Infectious Mononucleosis: A case report.

Seung Ah Lee, Hyun Ee Yim, Young Yul You, Jang Hee Kim

Department of Pathology, Ajou University School of Medicine, Suwon, Korea. mrkjhk@yahoo.co.kr

Abstract

Infectious mononucleosis(IM) is a benign self-limiting disease and result from a polyclonal B cell proliferation secondary to Epstein-Barr virus (EBV) infections. The infection is controlled by cytotoxic T cells triggered by EBV infected B cells. However, rare cases develop severe or fatal IM accompanied by hemophagocytic syndrome. We report a case of a 4-year-old girl who presented with high fever, hepatosplenomegaly, hepatic failure, pancytopenia and coagulopathy. Despite intensive treatment, the patient's condition deteriorated rapidly and died 3 days after admission. At autopsy, there was prominent infiltration of atypical lymphocytes with hemophagocytosis in multiple organs, especially liver, spleen and lymph nodes. Atypical lymphocytes were immunopositive for T cell markers and showed positive signal in EBV in situ hybridization.

Key Words: EBV, Infectious mononucleosis, autopsy, hemophagocytic syndrome