EB病毒與巨細胞病毒共同感染引起之傳染性單核球增多症：個案報告暨文獻回顧

A Case Report About Infectious Mononucleosis Caused by Co-infection of Epstein-Barr virus and Cytomegalovirus

鄧穩莊(Wen-Zhuang Then) ； 邱晨瑞(Chen-Jui Chiu) ； 林武甫(Wu-pu Lin) ； 陳宜君(Yee-Chun Chen)

《內科學誌》 27卷6期 (2016/12) Pp. 342-346

https://doi.org/10.6314/JIMT.2016.27(6).07

摘要

傳染性單核球增多症(infectious mononucleosis)好發於青少年及小孩，症狀大多輕微，多以血清學檢驗作為診斷工具。病原體以EB病毒(Epstein-Barr virus，簡稱EBV)為最大宗，巨細胞病毒(cytomegalovirus，簡稱CMV)第二。此病症多源於單一感染，兩者共同感染(co-infection)的確診案例很少。本篇報告一名34歲女性疑似巨細胞病毒急性感染(primary infection)合併EB病毒感染，同時有肋膜積水。此病人巨細胞病毒和EB病毒兩者IgM效價同時上升為較罕見之案例，故藉此討論其血清學診斷依據，進一步分析共同感染症狀加劇之可能機制。

關鍵字

EB病毒(Epstein-Barr virus) ； 巨細胞病毒(Cytomegalovirus) ； 共同感染(Co-infection) ； 傳染性單核球增多症(Infectious mononucleosis) ； 肋膜積水(Pleural effusion)

並列摘要

Infectious mononucleosis is a clinical syndrome particularly affects adolescents and children, most often caused by Epstein-Barr virus (EBV) and rarely caused by cytomegalovirus (CMV). Most cases of infectious mononucleosis are mild and resolve easily with minimal treatment and usually confirmed by a serologic test. Single infection of EBV or CMV causing infectious mononucleosis is common, while co-infection with these two viruses is relatively rare. This case report discusses a 34 year-old female patient presenting with the classical features of infectious mononucleosis along with pleural effusion. Pleural effusion is rarely associated with infectious mononucleosis. Blood serology was unusual in demonstrating elevated IgM titers to both CMV and EBV, suggestive of co-infection.