Respiratory obstruction resulting in death in one instance and requiring tracheotomy in eight instances has been reported in patients with anginose infectious mononucleosis. This is a report of a patient with infectious mononucleosis in whom the symptoms and signs of respiratory obstruction were severe enough to warrant a tracheotomy but who instead was first treated by intravenously administered corticotropin (ACTH).
REPORT OF CASE
An 18-year-old white male was first seen because of the onset of sore throat, dysphagia, hoarseness, swelling of the neck, weakness, malaise, headache, chills, and generalized aching of two days' duration. A diagnosis of "pharyngitis" was made at the onset of his illness, and he was given 300,000 units of procaine penicillin intramuscularly for two days. When the symptoms progressed, the dose of penicillin was increased to 600,000 units daily. Because he failed to respond to this treatment, he was admitted to the hospital. His history revealed