Acute Systemic Viral Infection Masquerading as an Infiltrating Lymphoma in an Elderly Patient: A Case Report and Review of the Literature

Table 2

Common characteristics of infectious mononucleosis in elderly patients in comparison to younger patients.

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Symptoms and signs

 Jaundice

 Prolonged fevers

 Hepatosplenomegaly

 Generalized lymphadenopathy

 Rashes

 Rarely neurological symptoms

Laboratory tests

 Lack of lymphocytosis

 Heterophile-negative antibody test (increases with age)

 Significant hyperbilirubinemia

 Elevation in liver function tests

 Positive EBV serology

Outcome

 Protracted duration of illness

 Prolonged hospitalizations

Common workup

 Blood tests including serologies

 Lymph nodes/liver biopsies

 Bone marrow aspiration and biopsies

 Imaging studies including MRI/CT scans

 Bronchoscopies

 ERCP

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ERCP: endoscopic retrograde cholangiopancreatography. References: Horwitz et al., 1983 [3], and Axelrod and Finestone, 1990 [1].