Primary Infection by Epstein–Barr Virus Presenting as Aplastic Anemia

Abstract

To the Editor: Aplastic anemia occasionally follows infectious mononucleosis.^{1 , 2} We have observed a case of aplastic anemia occurring simultaneously with clinically inapparent primary infection with Epstein–Barr virus (EBV), the etiologic agent of infectious mononucleosis.A previously healthy 12-year-old girl had bruising and epistaxis a week after a brief episode of sore throat. The initial physical and laboratory evaluation revealed only bruises, petechiae, and thrombocytopenia; a bone-marrow aspiration showed severe generalized depletion. Hematopoiesis became irreversibly absent within two weeks, and marrow-biopsy specimens showed no hematopoietic precursors, confirming the diagnosis of aplastic anemia by strict criteria.¹ A suitable marrow-transplant donor could not . . .