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J. Clin. Med. 2017, 6(9), 83; doi:10.3390/jcm6090083

Unexplained Dyspnea in a Young Adult with Epstein–Barr Virus Infectious Mononucleosis: Pulmonary Involvement or Co-Infection with Mycoplasma pneumoniae Pneumonia?

1
Infectious Disease Division, Winthrop-University Hospital Mineola, NY 11501, USA
2
State University of New York, School of Medicine, Stony Brook, NY 11790, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Emmanuel Andrès
Received: 3 August 2017 / Revised: 23 August 2017 / Accepted: 24 August 2017 / Published: 4 September 2017
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Abstract

Clinically, in young immunocompetent adults, Epstein-Barr virus (EBV) usually manifests as infectious mononucleosis (IM). Typical clinical findings of EBV IM include fever, profound fatigue, pharyngitis, bilateral posterior cervical adenopathy, and splenomegaly. Respiratory involvement with EBV IM may occur, but is distinctly rare. We present a case of a 20 year old female who with classic EBV IM, but was inexplicably dyspneic and hypoxemic. Further diagnostic testing confirmed co-infection with Mycoplasma pneumoniae. As a non-zoonotic atypical community-acquired pneumonia (CAP), M. pneumoniae may rarely be accompanied by severe hypoxemia and even acute respiratory distress syndrome. She represented a diagnostic dilemma regarding the cause of her hypoxemia, i.e., due to EBV IM with pulmonary involvement or severe M. pneumoniae CAP. The patient slowly recovered with respiratory quinolone therapy. View Full-Text
Keywords: bacterial and viral co-infection; non-exudative pharyngitis; community-acquired pneumonia; atypical pneumonia; cold agglutinins; atypical lymphocytosis; elevated serum transaminases bacterial and viral co-infection; non-exudative pharyngitis; community-acquired pneumonia; atypical pneumonia; cold agglutinins; atypical lymphocytosis; elevated serum transaminases
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MDPI and ACS Style

Cunha, B.A.; Herrarte Fornos, S. Unexplained Dyspnea in a Young Adult with Epstein–Barr Virus Infectious Mononucleosis: Pulmonary Involvement or Co-Infection with Mycoplasma pneumoniae Pneumonia? J. Clin. Med. 2017, 6, 83.

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