Infectious mononucleosis: A case report of 17 year-old man with cervical lymphadenopathy advised to biopsy

Infectious mononucleosis is an acute, self-limited, benign illness that occurs in children and young adults. In this case we describe a 17 year ­old man referred to our hospital with complaints of 1 month history of lymphadenopathy. Early presentation of disease in our case was cervical lymphadenopathy without fever or pharyngitis. In primary evaluation of the patient ac­cording to negative Mono test, 5% atypical lymph, elevated LDH and with considering probability of lymphoma he was advised to biopsy. Three weeks later he decribed exudative pharyngitis accompanying with fever and 7 days after recovery of sore throat when we visit him, he had fever, multiple lymph nodes on right side of neck, hepatomeg­aly and splenomegaly on examination. There was 10% atypical lymph in first CBC after admission that arises to 30% after 1 week. Under our close observation the patient's fever discon­tinued and tenderness and size of cervical lymphadenopathy decreased. EBV Ab (VCA) IgG and lgM were positive. EBV related infectious mononucleosis was confirmed. Therefore accelerated approach for lymph node biopsy isn't indicated before completion of 4 weeks period of observation