Cytomegalovirus Mononucleosis in Previously Healthy Individuals: Five New Cases and Follow-up of 13 Previously Published Cases

Five further cases of cytomegalovims (CMV) mononucleosis in previously healthy individuals are reported. This raises the total number of such patients seen by the authors to 18, all but one of whom were adults. A significant rise of complement-fixing antibodies to CMV was found during the disease. Cytomegalovirus was isolated from the urine of four patients. The disease was characterized by protracted fever, liver involvement, absence of pharyngitis and lymph node enlargement, hematologic changes similar to those seen in infectious mononucleosis, and a negative finding on the heterophil-agglutination test. A mixed cryoimmunoglobulinemia and other immunologic aberrations were found in three cases and intranuclear inclusion-bearing cells in the urine in three cases.

Virologic and clinical follow-up studies have been performed in patients of the present as well as of previous series. Cytomegalovirus is often excreted in the urine for 1 to 2 years after the illness. Hepatosplenomegaly was found in one patient, a young child, 4 months after the illness. In the other cases nothing suggestive of liver disease has been observed after the results of liver function tests became normal within some weeks or months. In several cases lymphocytosis without the appearance of atypical lymphocytes continued for many months and even years after the illness.