A case of infectious mononucleosis associated with bilateral peritonsillar abscess

Abstract

An 18-year male with fever, sore throat and poor oral intake was admitted to our hospital. Based on the pharyngeal findings and laboratory data including leukocytosis with lymphocytes predominance and atypical lymphocytes, and liver dysfunction, infectious mononucleosis （IM） was diagnosed. This was established based on elevated EBV titer VCA-IgM two days later. However, the detailed pharyngeal examination at admission suggested pharyngeal edema which was atypical in IM. CT with contrast enhancement revealed bilateral peritonsillar abscess （PTA）. The patient recovered well after conservative treatment including intravenous injection of antibiotics and needle aspiration of the bilateral abscesses. The association of PTA, especially bilateral ones, with IM is rare. Therefore, even if one is diagnosed, differentiation of association with others should be considered.