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Article
May 5, 1956

INFECTIOUS MONONUCLEOSIS MASKING CONCURRENT STREPTOCOCCIC PHARYNGITIS

JAMA. 1956;161(1):13-16. doi:10.1001/jama.1956.02970010015004
Abstract

• In two patients with concomitant cases of infectious mononucleosis and streptococcic pharyngitis, a copious growth of beta hemolytic streptococci on blood agar and increasing antistreptolysin 0 titers were obtained. From the standpoint of the differential blood cell count, however, all evidence of the coexisting bacterial infection was obscured. The absolute lymphocytosis and high percentage of young lymphocytes characteristic of infectious mononucleosis concealed the leukocytosis and neutrophilia characteristic of streptococcic pharyngitis.

Changes in the electrocardiogram and sedimentation rate were more marked than in uncomplicated cases of infectious mononucleosis. This experience casts doubt on some teachings regarding the "protean" manifestations of this disease. Unusual findings cannot be ascribed to infectious mononucleosis per se unless throat cultures, antistreptolysin determinations, and sedimentation rates have eliminated the possibility of concomitant streptococcic infection.

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