ABSTRACT: A case of infectious mononucleosis (IM) in a previously healthy 43-year-old male is presented. The patient complained of fever and a sore throat of 3 weeks' duration. Although blood tests showed a marked increase in atypical lymphocytes, tests for Epstein-Barr virus (EBV) and cytomegalovirus (CMV) were negative. Human immunodeficiency virus type 1 (HIV-1) antibody was positive on enzymelinked immunosorbent assay (ELISA), and the HIV-1 viral load was 6.4×10⁴copies/mL. Western blot (WB) analysis did not initially confirm HIV-1 infection ; however, HIV-1 infection was confirmed one month after presentation. Although several pathogens can cause infections presenting as IM, in Japan there have been few reports of acute retroviral syndrome presenting as IM. This case is being reported to stress the importance of the early diagnosis of acute retroviral syndrome.

PURPOSE: In cardiac 2-[F-18]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) examination, interpretation of myocardial viability in the low uptake region (LUR) has been difficult without additional perfusion imaging. We evaluated distribution patterns of FDG at the border zone of the LUR in the cardiac FDG-PET and established a novel parameter for diagnosing myocardial viability and for discriminating the LUR of normal variants. MATERIALS AND METHODS: Cardiac FDG-PET was performed in patients with a myocardial ischemic event (n = 22) and in healthy volunteers (n = 22). Whether the myocardium was not a viable myocardium (not-VM) or an ischemic but viable myocardium (isch-VM) was defined by an echocardiogram under a low dose of dobutamine infusion as the gold standard. FDG images were displayed as gray scaled-bull's eye mappings. FDG-plot profiles for LUR (= true ischemic region in the patients or normal variant region in healthy subjects) were calculated. Maximal values of FDG change at the LUR border zone (a steepness index; S(max) scale/pixel) were compared among not-VM, isch-VM, and normal myocardium. RESULTS: S(max) was significantly higher for n-VM compared to those with isch-VM or normal myocardium (ANOVA). A cut-off value of 0.30 in Smax demonstrated 100% sensitivity and 83% specificity for diagnosing n-VM and isch-VM. S(max) less than 0.23 discriminated LUR in normal myocardium from the LUR in patients with both n-VM and isch-VM with a 94% sensitivity and a 93% specificity. CONCLUSION: S(max) of the LUR in cardiac FDG-PET is a simple and useful parameter to diagnose n-VM and isch-VM, as well as to discriminate thr LUR of normal variants.
Aged ; Aged, 80 and over ; Echocardiography ; Female ; Fluorodeoxyglucose F18/*metabolism ; Humans ; Male ; Middle Aged ; Myocardial Infarction/metabolism/pathology ; Myocardium/*metabolism/*pathology ; Positron-Emission Tomography ; Young Adult