Abstract
The clinical condition commonly designated in this country as infectious mononucleosis, but classified elsewhere as glandular fever or monocytic angina, remains undetermined in etiology despite the attempts undertaken to clarify its nature. The more definite reports on this subject disclose a single observation by Nyfeldt 1 which suggests the causative agent to be an organism of the Listerella group. subsequently named Bact. monocytogenes hominis. More recently, Bland 2 expressed the opinion that a protozoön of the species Toxoplasma might be causally related to the disease. His study indicates that the “toxoplasma of glandular fever” is immunologically inseparable from T. cuniculi, but differentiable from the latter by its absolute virulence for monkeys and its greater virulence for rabbits. Since the etiology of this disease is still obscure and even disputed, it seems important to place on record observations made in our laboratories on a patient with infectious mononucleosis.
The clinical history of the individual studied is characterized by the more or less typical manifestations of the disease, which ran a course of about 3 weeks. A white girl, 16 years of age, had undergone chills, fever, and general malaise for 5 days preceding entry into the Monmouth Memorial Hospital. Upon admission, she complained of a severe angina, and on physical examination she was found to have a temperature of 102°F, enlarged cervical and axillary glands, and a palpable spleen, with no other particular signs. The results of her urinalysis were well within normal limits, while her blood gave a hemoglobin value of 76%, with a red-cell count of 3,300,000 and a white-cell count of 11,000, consisting of 23% polymorphonuclear cells, 37% lymphocytes, and 40% monocytes. Several blood enumerations were made during her stay in the hospital, and these revealed a fairly uniform hemoglobin and red-cell count, while the white-cell count reached as high as 17,700, with polymorphonuclears as low as 12% and both lymphocytes and monocytes attaining abnormally high figures.
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