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Abstract
Epstein–Barr virus (EBV) infection is nearly ubiquitous. While most primary EBV infections are mild and self-limited, occasional patients will develop severe complications of infectious mononucleosis (IM). Potentially fatal complications include fulminant hepatic failure, virus associated hemophagocytic syndrome and lymphoproliferative disorders. We report the case of an apparently immunocompetent 21-year-old woman with IM that progressed within weeks from a polyclonal B cell proliferation to a fatal B cell lymphoma.