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Fatal Massive Hepatic Necrosis in Cytomegalovirus Mononucleosis

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Thomas Jefferson University, Philadelphia, Pennsylvania

Ann Intern Med. 1978;88(6):810-812. doi:10.7326/0003-4819-88-6-810
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Cytomegalovirus Mononucleosis is an acute febrile illness characterized by atypical lymphocytosis (1). The clinical picture strikingly resembles infectious mononucleosis with generalized malaise and splenomegaly. Persistently negative heterophil-antibody tests are an important laboratory finding in distinguishing this syndrome from Epstein-Barr virus-induced infectious mononucleosis.

Hepatic involvement is a common finding in cytomegalovirus mononucleosis as manifested by mild hepatomegaly, consistent increases in serum transaminase activity, and variable elevation of serum alkaline phosphatase and bilirubin. We present here a case of fatal massive hepatic necrosis in a patient with cytomegalovirus mononucleosis.

A 33-year-old previously healthy man had a 2-week history of fever, malaise, night


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