INFECTIOUS MONONUCLEOSIS: REPORT OF AN EPIDEMIC IN AN ARMY POST*

Abstract

In 23% of 223 patients in whom electrocardiograms were taken, there were abnormalities in the T-waves, the P-R interval or both. The T-waves were either abnormally low, isoelectric or inverted and showed a peculiar waxing and waning in amplitude for as long as 6 months. T1 showed the greatest change in the great majority. A prolonged P-R interval persisted for 4 to 9 months in half of those with this phenomenon. Clinically, these cases tended to be more severely ill than those without electrocardiographic abnormalities and were subject to more frequent relapses. Cardiac findings were scanty except for a faint systolic murmur audible in 41%. Abnormal urinary findings were found in 3% of entire series. The course was uniformly benign. Dermatologic manifestations occurred in 16% and were classified as macular, morbilliform and scarlatiniform maculo-papular, polymorphous, nodular, vesicular, urticarial, hemor-rhagic and alopecia. Morbilliform and scarlatiniform eruptions were the most frequent. One patient had definite involvement of the central nervous system with pleocytosis and markedly increased protein in the spinal fluid. A relapse occurred in 9%. The incubation period was between 7 and 9 days. The typical hemogram was an initial leukocytosis or normal count with either normal or elevated neutrophiles, followed rapidly by a drop to normal or leukopenic values and a rising mononucleosis. A heterophile antibody agglutination titer of 1:112 or above was present in 62%. The Davidsohn absorption test was not uniformly confirmatory in the cases in which it was performed. Increased agglutinins for Eberthella typhosa and for several other bacteria were found in a significant number of those tested. Biologic false positive reactions for syphilis were found in 3%. Hemolytic streptococci were present in 41% of throat cultures and Vincent''s organisms in 67% of those tested. Sulfadiazine had no appreciable effect upon the course or the duration of the disease. 81 refs.