An infectious mononucleosis case [Bir enfeksiyöz mononükleoz olgusu]
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Epstein-Barr virus (EBV) is transmitted through intimate contact and the portal of entry is usually the lympho-epithelial cells lining the oral cavity where a persistent infection is established. The virus-host interaction is usually sub-clinical in young children. A 20-month-old male presented with long-lasting high fever of unknown origin. Generalized lymphadenopathy and an exantematous rash on the back of the patient were detected on physical examination. Antibodies against EBV, rubella, CMV and HSV were detected in the initial blood samples and the avidity of IgG class antibodies was evaluated. Low avidity of EBV-VCA IgG was detected and, other serological tests for EBV were performed. Infectious mononucleosis was diagnosed upon positive test results. Previous studies reporte that, during infections by viruses that may cause latent infections, polyclonal B lymphocytes are activated, producing antibodies against other viruses. As a result, in patients with exanthematous rash, IgM and IgG class antibodies along with avidity tests should be evaluated for differential diagnosis. Copyright © 2007 by Türkiye Klinikleri.