Assuntos
Antibacterianos/uso terapêutico , Apendicectomia/efeitos adversos , Bacteroidetes/efeitos dos fármacos , Bacteroidetes/isolamento & purificação , Eubacterium/efeitos dos fármacos , Eubacterium/isolamento & purificação , Peritonite/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Apendicite/cirurgia , Bacteroidetes/genética , Eubacterium/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peritonite/etiologia , Peritonite/microbiologia , RNA Ribossômico 16S , Sepse/tratamento farmacológico , Sepse/etiologia , Sepse/microbiologia , Resultado do TratamentoRESUMO
Suspicion threshold for opportunistic coinfections should be lowered in severe COVID-19. Serum CMV polymerase chain reaction and colonoscopy should be discussed in presence of persistent digestive disturbances.
RESUMO
The serological prevalence of Epstein-Barr virus (EBV) among young adults exceeds 90% worldwide. Even though EBV primary infection is usually benign, severe complications can occur in adolescents and young adults and so the disease must be promptly diagnosed. The development of an oropharyngeal abscess leading to a descending necrotizing mediastinitis (DNM) is exceptional and potentially lethal, so early diagnosis with a CT scan, appropriate antibiotics and surgery are essential. The authors present a case where DNM was associated with reactive hemophagocytic syndrome as a result of infectious mononucleosis, as well as a review of similar cases in the English literature. LEARNING POINTS: The incidence of serious complications in Epstein-Barr virus (EBV) primary infection increases with age.Respiratory symptoms (e.g., pleuritic pain, dyspnoea) and unusually prolonged fever (>10 days) in patients with infectious mononucleosis could be 'red flags' for life-threatening complications such as empyema and descending necrotizing mediastinitis.The threshold for performing cervical and chest computed tomography in septic patients with infectious mononucleosis should be low.
