A 13-year-old female patient, with no personal history of interest, complaining of bilateral pleural edema of three days duration.
The patient reported accompanying headache with mild odynophagia without associated fever.
Physical examination revealed bilateral vestibular edema without other abnormalities. No edema was observed in other locations, and hypertrophy was observed in 2/4 without exudates.
In the following days, the patient returned to the hospital due to persistent fever and increased fever, without other symptoms.
Urine dipstick was performed on several occasions without detecting proteinuria and culture of pharyngeal exudate which was negative.
ALT increased and negativity of tests performed so far, blood count, blood chemistry, liver profile and urine sediment were requested with normal results except leukocytosis (18 460/μL) with lymphocytic predominance ( 184 UIPT/μL).
Ten days after the onset of the clinical picture, edema and fever, adenopathies and hepatomegaly resolved.
Analytical control was performed at three weeks of CBC without alterations and decreased transaminase levels to normal (GOT 22 IU/l, GPT 16 IU/l).
The suspicion of mononucleic syndrome requires serology of EBV and cytomegalovirus (CMV), obtaining IgM against EBV which allows diagnostic confirmation.
