Co-infection by two or more pathogens is a common finding in infectology. However, the simultaneous infection by two viruses such as the Epstein-Barr virus (EBV) and the severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) has not been reported to date. In the context of a coronavirus pandemic (COVID-19), any infectious clinical condition is suspected of COVID-19. The lockdown of the population sometimes makes us forget that other pathogens can also be transmitted and manifest themselves.
A 19-year-old French woman, with no relevant history, came to the emergency department with a two-day history of fever, bilateral eyelid oedema, and right hemifacial swelling. In addition to the skin manifestations, the physical examination showed bilateral cervical lymphadenopathy, non-suppurative pharyngotonsillitis, and splenomegaly.
The results of the lab tests and the serological study are summarized in Table 1. The presence of SARS-CoV-2 RNA was detected in the reverse transcriptase polymerase chain reaction (RT-PCR) of the sample obtained by oronasopharyngeal swab. The presence of EBV was also detected by PCR in blood (4700 copies/mL) and plasma (9600 copies/mL). The mumps virus could not be detected in the saliva cell culture.
An anteroposterior chest radiograph and a computed tomography (CT) scan of the chest and abdomen showed splenomegaly (diameter greater than 16 cm) in the absence of pulmonary pathological findings. With a diagnosis of infectious mononucleosis (IM) mimicking mumps and asymptomatic Covid-19, in the absence of other complications, exclusively symptomatic and supportive treatment was recommended. The patient experienced a significant clinical improvement after two weeks of follow-up.
CITA DEL ARTÍCULO Med Clin (Engl Ed). 2020 Sep 12. doi: 10.1016/j.medcle.2020.06.010