Infectious Mononucleosis Resulting in Acute Necrotizing Mediastinitis: A Case Report and Literature Review
  • Héloïse Van Noten
    Internal Medicine and Infectious Diseases Department, C.H.U de Charleroi, Lodelinsart, Belgium
  • Samuel Markowicz
    Internal Medicine and Infectious Diseases Department, C.H.U de Charleroi, Lodelinsart, Belgium
  • Serge Cappeliez
    Cardio-Thoracic Surgery Department, C.H.U de Charleroi, Lodelinsart, Belgium
  • Soraya Cherifi
    Internal Medicine and Infectious Diseases Department, C.H.U de Charleroi, Lodelinsart, Belgium

Abstract

The serological prevalence of Epstein-Barr virus (EBV) among young adults exceeds 90% worldwide. Even though EBV primary infection is usually benign, severe complications can occur in adolescents and young adults and so the disease must be promptly diagnosed. The development of an oropharyngeal abscess leading to a descending necrotizing mediastinitis (DNM) is exceptional and potentially lethal, so early diagnosis with a CT scan, appropriate antibiotics and surgery are essential. 
The authors present a case where DNM was associated with reactive hemophagocytic syndrome as a result of infectious mononucleosis, as well as a review of similar cases in the English literature.

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References

  • Tattevin P, Le Tulzo Y, Minjolle S, Person A, Chapplain JM, Arvieux C, et al. Increasing incidence of severe Epstein-Barr virus-related infectious mononucleosis: surveillance study. J Clin Microbiol 2006;44(5):1873–1874.
  • Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett’s principles and practices of infectious diseases. 8th ed. Philadelphia, PA: Churchill Livingstone; 2015.
  • Hagelskjaer Kristensen L, Prag J. Human necrobacillosis, with emphasis on Lemierre's syndrome. Clin Infect Dis 2000;31(2):524–532.
  • Fardet L, Galicier L, Lambotte O, Marzac C, Aumont C, Chahwan D, et al. Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome. Arthritis Rheumatol 2014;66(9):2613–2620.
  • Fisman DN. Hemophagocytic syndromes and infection. Emerg Infect Dis 20006(6):601–608.
  • Kopec SE, Irwin RS, Mello CJ, Umali CB. Bilateral anaerobic empyemas complicating infectious mononucleosis. Chest 1997;112(3):833-835.
  • Andrianakis IA, Kotanidou AN, Pitaridis MT, et al. Life-threatening bilateral empyema and mediastinitis complicating infectious mononucleosis. Intensive Care Med 2002;28(5):663-664.
  • Chandak TR, Wong P, Hussain E, Kim A. Fulminant descending mediastinitis, bilateral empyema and respiratory failure: a rare complication of infectious mononucleosis (IM). Am J Respir Crit Care Med 2011;183;2011:A5703.
  • Nguyen D-V, Kenny J-E, Chin M, Chapman JM, Chung J, Kirsch C et al. A sore throat complicated by pneumomediastinum. Am J Respir Crit Care Med 2012;185;2012:A5946.
  • Geerts JW, van Driel EM, Janssen MJ. Descending mediastinitis in Epstein-Barr virus infection. J Clin Microbiol 2015;53(5):1781-1782.
  • Lloyd T, Tran VK. Acute Mediastinitis as a Complication of Epstein-Barr Virus. CJEM 2016;18(2):149-151.
  • Clotet S, Matas L, Pomar V, Casademont J. Acute mediastinitis as a rare complication of an infectious mononucleosis. Enferm Infecc Microbiol Clin 2018;36:602-603.
  • Fuller GW, Rao JN. Fulminant descending mediastinitis secondary to infectious mononucleosis. J Surg Case Rep 2018;2018(8):rjy203. Published 2018 Aug 7.
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    Published: 2020-08-24
    Issue: 2020: Vol 7 No 11 (view)


    How to cite:
    1.
    Van Noten H, Markowicz S, Cappeliez S, Cherifi S. Infectious Mononucleosis Resulting in Acute Necrotizing Mediastinitis: A Case Report and Literature Review . EJCRIM 2020;7 doi:10.12890/2020_001829.