An infectious mononucleosis-like syndrome induced by minocycline: A third pattern of adverse drug reaction

A 22-year-old black man developed fever chills, fatigue, night sweats, tend er lymphadenopathy, and a generalized, pruritic, macular eruption 3 weeks a fter starting minocycline therapy for acne. His illness was also characteri zed by a palpable spleen tip, marked lower extremity and scrotal edema, and generalized lymphadenopathy. The patient had leukocytosis with a large per centage of atypical lymphocytes on peripheral smear and liver dysfunction. Titers for Epstein-Barr virus, hepatitis B, toxoplasmosis, and cytomegalovi rus were all negative. Human immunodeficiency virus-1 viral load and antibo dies were also negative. Marked improvement was noted after the discontinua tion of minocycline and the use of systemic corticosteroids. With the negat ive viral serologies, the clinical picture was most consistent with an infe ctious mononucleosis-like syndrome produced by the minocycline ingestion.