INFECTIOUS MONONUCLEOSIS WITH JAUNDICE AND ABDOMINAL PAIN AS PRESENTING COMPLAINTS: REPORT OF CASE

Abstract

A case of infectious mononucleosis, encountered at the Mayo Clinic, is presented. Jaundice and abdominal pain were the presenting symptoms at a time when pharyngitis and enlargement of lymph nodes had not yet appeared. This combination of symptoms, together with the finding of a markedly elevated value for serum alkaline phosphatase, suggested the diagnosis of disease of the extra-hepatic biliary tract. On the other hand, the prodromal symptoms of the patient''s illness and the positive results for cephalin-cholesterol flocculation and thymol turbidity tests suggested infectious hepatitis. It was only by the determination of the heterophil antibody titer that the true nature of the patient''s illness became apparent. While involvement of the liver is common in infectious mononucleosis, the combination of jaundice and severe abdominal pain is an unusual occurrence.