title: A case of cytomegalovirus mononucleosis associated with pleural effusion.
abstract: A 5 year old boy had a spiky fever accompanied by a mild pharyngitis, cervical lymphadenopathy and hepatosplenomegaly. Laboratory findings revealed leukocytosis with 26% atypical lymphocytes, and liver dysfunction. A chest X-ray showed pneumonia and a considerable amount of pleural effusion. Serum antibody titers for cytomegalovirus (CMV) were elevated significantly and CMV-DNA (polymerase chain reaction) was detected in the pleural effusion. Only 13 cases of pleural effusion associated with infectious mononucleosis have been reported previously in the literature, but there was no documentation that proved CMV infection. The case reported here suggests that the pleural effusion was caused by the infiltration of mononuclear cells to the pleura as a result of systemic inflammation, and the possible alternative of host immune response against CMV was related to recent Varicella zoster virus infection.
authors.affiliation: Department of Pediatrics, Kanagawa Prefecture Midwives and Nurses Training School Hospital, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kato
authors.forename: I
authors.initials: I
authors.lastname: Miyata
authors.forename: S
authors.initials: S
authors.lastname: Sakuma
authors.forename: A
authors.initials: A
authors.lastname: Katayama
authors.forename: S
authors.initials: S
authors.lastname: Toyoda
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: N
authors.initials: N
authors.lastname: Okabe
authors.forename: K
authors.initials: K
authors.lastname: Maekawa
mesh_terms: D000914:Antibodies, Viral / Q000032:analysis; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000150:complications*; D004279:DNA, Viral; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications*; D008297:Male; D010996:Pleural Effusion / Q000209:etiology*; D016133:Polymerase Chain Reaction
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral