頸部蜂窩織炎と思われたInfectious Mononucleosis症例

Cervical Phlegmon in Case of Infectious Mononucleosis

I．はじめに

　頸部腫脹を来す疾患の本態解明には，困難を極めることが多い。通常，炎症性，腫瘍性，先天性のものがある。今回我々は，発熱と一側性頸部腫脹を来し，頸部蜂寓織炎と初診時診断した例が，さらに術前精査した結果，infectious mononucleosis（IMと略）であった症例を経験した。これら臨床像の他，著しい腹部症状を伴い，また，異種血球凝集価が吾明な高値を呈した。頭部腫脹の鑑別診断上の要注意例として症例を呈示し，あわせて文献的考察を加え，報告した。

　A case of infectious mononucleosis in a 25-year-old Caucasian male with fever and remarkable swelling of the neck was reported. He had noticed a low grade fever, diarrhea, lower abdominal pain, general fatigue, sore throat and cervical swelling with lymphadenopathy. Tentative diagnosis on the first visit was made as cervical phlegmon due to aggravated chronic tonsillitis. During the admission, characteristic laboratory findings, i.e., numerous atypical lymphocytes in blood, elevation of GOT, GPT, LDH and very high titer of heterophil agglutinin were reported to be apparently due to infectious mononucleosis. Therefore, surgical treatment on the cervical swelling was avoided.