Abstract
Infectious mononucleosis is a clinical syndrome characterized by fever, lymphadenopathy and pharyngitis. Neurologic complications of infectious mononucleosis, such as the development of Guillain-Barre syndrome, have been rarely reported and usually present late in the course of the disease. We describe a case of a 29 year old male with no significant past medical history who was diagnosed with Guillain-Barre syndrome following an infection with Epstein-Barr virus associated infectious mononucleosis. Supportive treatment resulted in full recovery.
Highlights
We describe a case of a 29 year old male with no significant past o medical history who was diagnosed with e Guillain-Barre syndrome following an infection with Epstein-Barr virus associated infecs tious mononucleosis
The present case describes the development of two rare neurologic complications of infectious mononucleosis (IM) in the same patient
The occurrence of both GBS and Bell’s palsy within a short time span from the development of Epstein-Barr virus (EBV) associated IM supports the theory that these entities are variants of the same pathologic process
Summary
We describe a case of a 29 year old male with no significant past o medical history who was diagnosed with e Guillain-Barre syndrome following an infection with Epstein-Barr virus associated infecs tious mononucleosis. Peripheral blood smear showed large atypical lymphocytes-a hallmark finding of infectious mononucleosis. This was followed by heterophile antibody test, which was positive. Immunofluorescence assays of antibody titers to EBV antigens showed absence of EBNA IgG antibodies, Viral Capsid Antigen (VCA) (IgM) of 317 units (normal between 0-90 units), VCA (IgG) of 5 units, suggestive of an acute primary Epstein-Barr virus (EBV) infection. Lumbar puncture was performed and cerebrospinal fluid revealed white cell count 0 cells/dL, red cell count 4 cells/mm[3], glucose 60 mg/dL and protein 56 mg/dL. The findings of the CSF analysis further supported the diagnosis of Guillain-Barre syndrome
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