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Leukemoid Reaction in Infectious Mononucleosis An Infrequent Manifestation Simulating Leukemia

AMA Arch Intern Med. 1959;104(4):619-621. doi:10.1001/archinte.1959.00270100105017.
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Infectious mononucleosis, a common disorder in the young-adult age group, is well known for its protean features. Leukemia may be suggested when bleeding manifestations, thrombocytopenia, and hemolytic anemia are found in association with lymphadenopathy and splenomegaly. The leukocyte count rarely exceeds 30,000 per cubic millimeter.1 The following report is an example of infectious mononucleosis with the infrequent leukemoid response which may further mimic leukemia. The causes of a lymphocytic leukocytosis are reviewed.

Report of Case  The patient, an 18-year-old student, was admitted to the Peter Bent Brigham Hospital for the first time, on Nov. 20, 1956, because of fever of four days' duration. He had been well until nine days before entry, when sore throat, retro-orbital pain, and malaise began. Fever, headache, anorexia, nausea and vomiting, increasing malaise without chill, cough, chest pain, and gastrointestinal or genitourinary symptoms were noted during the four days before admission.Initial physical examination


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