Defined criteria to establish the diagnosis of infectious mononucleosis (IM) are essential before atypical presentations of this disease can be appreciated. Hoagland (1952) believed that a valid diagnosis of IM must fulfill three criteria: characteristic clinical manifestations, hematologic manifestations, and serology. The clinical findings should include a constellation of such signs as fever, cervical adenitis, pharyngeal inflammation, and, to a lesser extent, hepatomegaly and other signs. Minimal hematologic features are a relative lymphocytosis greater than 50 percent of all leukocytes and the presence of atypical lymphocytes for at least 10 days. Bender (1952) felt that atypical lymphocytes in the peripheral blood in IM should have an absolute concentration of at least 1,000/mm3 (many investigators currently use 10 percent of the leukocyte population as a minimal criterion). Hoagland (1952) also believed that a true case of IM must exhibit an appropriate serologic response, namely, the development of characteristic heterophile antibodies. The typical cases of IM have been described traditionally in young adult patients.
KeywordsInfectious Mononucleosis Atypical Presentation Young Adult Patient Atypical Lymphocyte Hematologic Manifestation
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