Fever of unknown origin (FUO) in an elderly adult due to Epstein-Barr virus (EBV) presenting as "typhoidal mononucleosis," mimicking a lymphoma

Burke A. Cunha, Andrew Petelin, Sonia George

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

We describe fever of unknown origin (FUO) in a 57-year-old woman with hepatosplenomegaly. The diagnostic workup was directed at diagnosing a lymphoma. Her history of travel and exposures to food and water did not make typhoid fever a likely diagnostic possibility. Because she presented with prolonged fevers, fatigue, anorexia, weight loss, and night sweats with hepatosplenomegaly, lymphoma was likely. Initially, Epstein-Barr virus (EBV) was not considered because of her age, the absence of pharyngitis and cervical adenopathy, and the higher likelihood of another diagnosis, ie, lymphoma. Eventually, her FUO was diagnosed as EBV presenting as "typhoidal mononucleosis." Typhoidal mononucleosis is an extremely rare presentation of EBV as a cause of FUO in an adult. All of her symptoms as well as her clinical and laboratory findings resolved spontaneously.

Original languageEnglish
Pages (from-to)79-81
Number of pages3
JournalHeart and Lung: Journal of Acute and Critical Care
Volume42
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

Keywords

  • EBV infectious mononucleosis in the elderly
  • EBV lymphomas
  • Elevated alkaline phosphatase
  • Elevated ferritin levels
  • Hepatosplenomegaly
  • Highly elevated erythrocyte sedimentation rate
  • Negative Naprosyn test

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