A case presenting symptoms of subacute necrotizing lymphadenitis following infectious mononucleosis

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We treated a Japanese woman who presented symptoms of subacute necrotizing lymphadenitis (SNL), which occurred following an EB virus infection, i.e., infectious mononucleosis (IM). No such cases have been reported and the possibility that SNL may be induced by an EB virus infection has to be given attention.The patient was a 26 year-old Japanese woman who admitted to Kyushu University Hospital because of persistent fever and sore throat. Systemic lymphadenopathy, hepatomegaly, leukocytosis, an increased number of atypical lymphocytes and the elevation of serum EB VCA-IgM titer were evident and the diagnosis of IM was made. Two months after the onset of IM, she again had a high fever and marked swelling of the left submandibular lymph nodes accompanied by marked tenderness. Serum markers of EB virus showed evidence of the convalescent stage of IM. Leukocytopenia was present and she recovered 40 days later with no specific treatment. Though SNL was not histologically proven, the diagnosis of SNL was made. Immunological investigations showed that the ratio of OKT 4+ to OKT 8+ lymphocytes was decreased and the natural killer cell activity had deteriorated.
日本臨床免疫学会の論文