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September 1950


Author Affiliations


From the Medical Service, Veterans Administration Hospital.

Arch Intern Med (Chic). 1950;86(3):391-401. doi:10.1001/archinte.1950.00230150074005

PHYSICIANS as an acute benign infectious disease of unknown causation with protean manifestations. Classically, it was recognized as primarily affecting the nasopharynx, accompanied with lymph node enlargement, splenomegaly, the appearance of large atypical bizarre lymphocytes in the peripheral blood and the development of heterophil agglutinations for sheep red cells as exemplified in the Paul-Bunnell test. The course is usually mild, the prognosis excellent and treatment symptomatic. However, reports of the occurrence of cutaneous eruptions, purpura and other hemorrhagic manifestations, pneumonitis, myocardial involvement, nephritis, meningeal irritation and a "visceral" or typhoidal type of infection withoutany peripheral local manifestations have testified to the fact that infectious mononucleosis is really a generalized infection.1

In view of these various manifestations of the disease Tidy2 distinguished three main types, dependent on the pertinent clinical features: 1. The glandular form occurs predominantly in children and is manifested after a short prodromal period by the