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Impressum
Exsudative retinal detachment in Epstein-Barr virus associated infectious mononucleosis. A case report.
1Uhlig C. E., 2Treder W., 3Meckling H., 1Gerding H., 1Busse H.
1Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, D-48129 Münster; 2Gemeinschaftspraxis für Labormedizin, Albrecht-Thaer-Straße 14, D-48061 Münster; 3Gemeinschaftspraxis für Radiologie, Von-Steuben-Strasse 10a, D-48143 Münster
Objective: Infectious mononucleosis is a common asymptomatic disease
in young patients and adolescents. We report on a patient who presented
with infectious mononucleosis and ocular complications.
Methods: Case report of a 14-year-old boy with dramatic loss of
visual acuity and deviation of his right eye.
Results: The patient presented with fever, pharyngitis, a splenomegaly,
cervical lymphadenopathy and an atypical lymphocytosis. Funduscopy revealed
a complete exsudative retinal detachment without rhegmatogenous, lattice
or proliferative degeneration. In ultrasonography signs for scleral inflammation
were not detected. Image scans of the optic nerve and nerve channel, the
vascular and lymphomatous sytem were regular. Toxoplasmosis, human imunodeficiency
virus, herpes virus, treponema and cytomegalovirus were negative, angiotensin
converting enzyme and serumelectrophoresis normal. There was no clinical
or serological evicence for lymphomatous diseases. Epstein-Barr virus-IgG
antibody was initially negative, Epstein-Barr virus-IgM decreasing. Treatment
was methylprednisolon/fluocortolon in the beginning as well as clarytromycin
and aciclovir per os. Due to a secondary glaucoma, steroids were changed
to non-steroidal antiophlogistics. Follow-up has been five months, outcome
has not changed since.
Conclusion: As far as we are aware, this is the first published
report on an Epstein-Barr Virus associated infectious mononucleosis with
complete exsudative retinal detachment.