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Postgrad Med J. 1987 April; 63(738): 277–279.
PMCID: PMC2428173

Bone marrow granulomas in mononucleosis.


Two patients with mononucleosis, one due to cytomegalovirus (CMV), and the other due to Epstein-Barr virus (EBV), presenting with high fever, malaise and hepatitis, had granulomas in the bone marrow but not in the liver. In patients who have unexplained fever, bone marrow granulomas may be a clue to CMV or EBV infection and need not initially raise the fear of prognostically more severe illness.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Gelb AM, Brazenas N, Sussman H, Wallach R. Acute granulomatous disease of the liver. Am J Dig Dis. 1970 Sep;15(9):842–847. [PubMed]
  • HOAGLAND RJ, MCCLUSKEY RT. Hepatitis in mononucleosis. Ann Intern Med. 1955 Nov;43(5):1019–1030. [PubMed]
  • Reller LB. Granulomatous hepatitis associated with acute cytomegalovirus infection. Lancet. 1973 Jan 6;1(7793):20–22. [PubMed]
  • Bonkowsky HL, Lee RV, Klatskin G. Acute granulomatous hepatitis. Occurrence in cytomegalovirus mononucleosis. JAMA. 1975 Sep 22;233(12):1284–1288. [PubMed]
  • Clarke J, Craig RM, Saffro R, Murphy P, Yokoo H. Cytomegalovirus granulomatous hepatitis. Am J Med. 1979 Feb;66(2):264–269. [PubMed]
  • Chambers TJ. Multinucleate giant cells. J Pathol. 1978 Nov;126(3):125–148. [PubMed]
  • SCHLEICHER EM. Reticulum hyperplasia and proliferation of lymphoid cells in the bone marrow in infectious mononucleosis. Acta Haematol. 1949 Aug;2(4):242–246. [PubMed]

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