# Severe Upper Airway Obstruction in a Patient With Infectious Mononucleosis

## TL;DR

A patient with infectious mononucleosis developed severe airway obstruction, which was successfully managed with corticosteroids.

## Contribution

The paper presents a case illustrating the use of corticosteroids for severe upper airway obstruction in infectious mononucleosis.

## Key findings

- An 18-year-old man with IM required intubation due to airway obstruction.
- CT scans showed tonsillar swelling, enlarged lymph nodes, and splenomegaly.
- Corticosteroids, antibiotics, and ventilatory support led to a positive outcome.

## Abstract

Infectious mononucleosis (IM) is a clinical disease caused by the Epstein-Barr virus (EBV). Common presenting symptoms include sore throat, lymph node enlargement, fever, and malaise. Although severe upper airway obstruction is uncommon, it is a potentially fatal complication that requires immediate intervention. We describe the case of an 18-year-old Hispanic man who presented with a progressive sore throat and difficulty speaking, requiring endotracheal intubation for airway protection. CT images showed diffuse swelling of Waldeyer’s tonsillar ring, multiple enlarged lymphadenopathies, and splenomegaly. Acute EBV infection was confirmed considering clinical presentation and using the heterophile antibody, anti-nuclear and anti-viral capsid antigens, and quantitative PCR. The patient was managed with ventilatory support, empirical antibiotic therapy, and systemic corticosteroids, achieving a positive outcome. Our case illustrates the use of corticosteroids in managing severe upper airway obstruction complicating IM.