Cytomegalovirus mononucleosis--a report of 70 cases in a community hospital.

Seventy consecutive cases of cytomegalovirus mononucleosis (CMV-MN) were examined retrospectively from their clinical, epidemiological and serological aspects. The mononucleosis syndrome was complicated by various specific organ involvement in 15 (21%) of the patients. Serial serum samples were examined for specific CMV IgG, IgA and IgM antibodies by either the immunoperoxidase or enzyme-linked immunoassay techniques, or both. Specific anti-CMV IgM antibodies were found in 57 patients whose blood samples were collected for the first time at the second week of illness. In seven patients, CMV infection was diagnosed by a rise of specific IgG antibodies and the presence of specific IgA antibodies. These seven patients were generally older (mean age 68 years); four of them had a malignant disease and probably represent cases of recurrent CMV infection. An association between malignancy and recurrent CMV infection in the older age-group is suggested. Prompt diagnosis of CMV infection may exclude CMV-MN from the list of fevers of unknown origin, thus avoiding laborious patient workups.