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PubMed1983

[Antibody formation against specific Epstein-Barr virus antigens in infectious mononucleosis with tonsillectomy in the acute phase of the disease].

In the present study, the clinical course and the specific humoral immunological response to Epstein-Barr virus antigens have been investigated in patients affected with infectious mononucleosis after tonsillectomy in the acute phase of the disease, compared against conservatively treated patients. Clinical results confirm that tonsillectomy in the acute phase of infectious mononucleosis has a favourable effect on the course of the disease, and reduces the duration of the disease by about half of the usual time. Statistically significant differences - indicating a confined, delayed humoral immunological response or unresponsiveness to some extent - regarding the examined antigens after tonsillectomy in the acute phase of infectious mononucleosis, could be observed between the two groups of patients in respect of the production of antibodies against viral capsid and nuclear antigens of the Epstein-Barr virus and heterophilic antibodies. For this reason, tonsillectomy should be suggested only as therapy of infectious mononucleosis in anginous courses of the disease which appear life-threatening.

Acute Disease↗
PubMed1983

Cold urticaria associated with infectious mononucleosis.

We have evaluated two patients with cold urticaria associated with infectious mononucleosis and reviewed three case reports with this syndrome. The cold sensitivity ranged from urticaria to anaphylaxis and one patient had additional cold-related cutaneous manifestations. The duration of cold urticaria was transient and paralleled the clinical course of infectious mononucleosis. Analysis of these five cases revealed no correlation of cold urticaria with known cold-activated factors that often occur in this viral infection.

Adolescent↗
PubMed1993

[A case of infectious mononucleosis syndrome caused by cytomegalovirus].

A case of 26-years old man with symptoms of infectious mononucleosis syndrome is presented. In the course of the disease: high temperature, weakness, loss of appetite, sore throat, myalgia, hepatomegaly, splenomegaly and some laboratory changes (leucocytosis with presence of atypical lymphocytes, elevated aminotransferase activity) have been observed. Serological tests have shoved: slighthly positive PBD-test in the first examination (second-negative) and the presence of IgM antibodies against CMV in a high titer with four-time decrease of the titer during the course of the disease. Because of the incomplete symptom complex for infectious mononucleosis caused by EBV we have put the diagnosis of cytomegaly coursed as a infectious mononucleosis syndrome.

Adult↗
PubMed2006

Recent advances in the understanding of infectious mononucleosis: are prospects improved for treatment or control?

Symptomatic primary Epstein-Barr virus infection is known more commonly as infectious mononucleosis, an illness known for afflicting adolescents and younger adults as a febrile illness accompanied by pharyngitis and lymphadenopathy. Historically believed to be generally benign, infectious mononucleosis has been linked more recently to increased risks of developing Hodgkin's lymphoma and multiple sclerosis. Advances in the understanding of host immune responses to Epstein-Barr virus have begun to elucidate the reasons why younger children typically experience subclinical infection whereas older individuals develop infectious mononucleosis. This review will highlight recent advances in the understanding of primary Epstein-Barr virus infection, and whether prospective treatments or vaccine strategies may affect native infection and its sequelae.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Prospective study of the natural history of infectious mononucleosis caused by Epstein-Barr virus.

BACKGROUND: Knowledge regarding the clinical characteristics and natural history of acute infectious mononucleosis is based largely on older, often retrospective, studies without systematic follow-up. Differences in diagnosis, methodology, or treatment between historical and current practice might affect an understanding of this illness. METHODS: Using a prospective case series design, we enrolled 150 persons with an acute illness serologically confirmed as Epstein-Barr virus infection. The goal of the study was to assess symptoms, physical examination findings, laboratory tests, and functional status measures during the acute presentation and 1, 2, and 6 months later. RESULTS: Acutely, infectious mononucleosis was characterized by the symptoms of sore throat and fatigue and substantial functional impairment. Objective physical and laboratory examination findings included pharyngitis and cervical lymphadenopathy, a moderate absolute and atypical lymphocytosis, and mildly elevated transaminase levels. The traditional signs of fever and splenomegaly were relatively uncommon. By 1 month, most symptoms and signs and all laboratory tests had returned to normal. Fatigue, cervical lymphadenopathy, pharyngitis, and functional health status improved more slowly. CONCLUSIONS: In contemporary practice most of the classical illness features of infectious mononucleosis are observed. Symptoms, signs, and poor functioning might be protracted in some patients.

Adolescent↗
PubMed1985

Life-threatening haemolytic anaemia and infectious mononucleosis. A case report.

A 36-year-old man with infectious mononucleosis presented with massive intravascular haemolytic anaemia. The diagnosis was established by a positive Paul-Bunnell test, the demonstration of IgM antibodies against Epstein-Barr virus capsid, and IgG antibody to early antigen. The direct and indirect antiglobulin tests were negative; the pathogenesis of the severe haemolysis was attributed to the temporary synthesis of anti-i cold agglutinin having a high thermal amplitude. Although life-threatening, the episode was short-lived and responded to supportive therapy with blood transfusion and folate administration only. This case illustrates a rare association between severe haemolytic anaemia and infectious mononucleosis, it emphasizes the value of IgM-specific fluorescent antibody tests in diagnosis when patients have otherwise unexplained haemolysis.

Adult↗
PubMed1980

Latex test for serodiagnosis of infectious mononucleosis.

A glycoprotein was isolated from bovine erythrocytes which has 20% carbohydrate and migrates on sodium dodecyl sulfate-polyacrylamide gel electrophoresis as a single band. This glycoprotein carries the reactivity of bovine erythrocytes with Paul-Bunnell heterophile antibody of infectious mononucleosis. This bovine glycoprotein was coupled to carboxyl-modified latex particles with water-soluble carbodiimide. The resulting reagent was then used to develop a new test for the detection of infectious mononucleosis antibody. The bovine erythrocyte glycoprotein-latex reagent is more stable than sheep or horse erythrocytes, the traditional reagents for detection of infectious mononucleosis antibody. This new reagent is used in a direct slide test; no preabsorption of the sera is necessary. In the present study the glycoprotein-latex reagent compared favorably in terms of sensitivity and specificity with two standard tests for infectious mononucleosis antibody. Ninety-nine serum samples were tested. Agreement of the latex test with a stabilized horse erythrocyte spot test was 90%. Ten samples were weakly positive with the latex test and negative with the horse cell test. Only one of these was also positive with an enzyme-treated sheep cell test. This latter test was somewhate more sensitive than the latex test.

Animals↗
PubMed1991

Lack of effect of peroral acyclovir for the treatment of acute infectious mononucleosis.

Perorally administered acyclovir was evaluated in the therapy of acute infectious mononucleosis in a multicentered, randomized, double-blind, placebo-controlled trial. A total of 120 patients received 600 mg of acyclovir or placebo five times daily for 10 days. All patients were entered into the study within 7 days of symptom onset and had a positive Monospot test. Analysis of mean values and time to resolution of fever, lymphadenopathy, weight change, hepatomegaly, splenomegaly, liver function tests, atypical lymphocytes, hours of bed rest, sense of well-being, and return to normal activities revealed no significant differences. There was a trend toward suppression of Epstein-Barr virus excretion in the oropharynx in acyclovir recipients. No toxicity was detected in patients treated with acyclovir. Under the conditions of the study, there was no evidence that treatment with perorally administered acyclovir affected the course of infectious mononucleosis.

Acyclovir↗
PubMed1985

Pericardial effusion as the sole manifestation of infectious mononucleosis.

A 56-year-old patient presented with fever, dyspnoea and large pericardial effusion, which were the only features of infectious mononucleosis. Atypical cases or infectious mononucleosis are common in older patients. Such a well documented case of effusive pericarditis, however, has not been previously recorded.

Dyspnea↗
PubMed2003

Hemolytic uremic syndrome linked to infectious mononucleosis.

A 12-month-old boy developed a mild hemolytic uremic syndrome with no acute diarrheal prodrome. The typical clinical, hematological, and serological features of infectious mononucleosis were also noted. The clinical course of both hemolytic uremic syndrome and infectious mononucleosis was uneventful. A review of the literature disclosed that hemolytic uremic syndrome has been noted in two adolescents with infectious mononucleosis.

Hemolytic-Uremic Syndrome↗
PubMed2000

[Conservative management of spontaneous splenic rupture as a complication of infectious mononucleosis: two case reports and literature review].

We report on conservative management of 2 patients with spontaneous splenic rupture associated with infectious mononucleosis. Both patients had an unremarkable hospital course and were discharged within 7 days of admission. Resolution of the haematoma was followed by ultrasound monitoring during the hospital stay. A literature review to 1999 shows that approximately 45 patients with serologically proven infectious mononucleosis have suffered spontaneous rupture of the spleen. Spontaneous splenic rupture is a rare but potentially fatal complication of infectious mononucleosis. Although splenectomy has been advocated in the past as the definitive therapy, we recommend that non-surgical management be considered in haemodynamically stable patients, to avoid the complications of splenectomy (e.g. post-splenectomy sepsis).

Adult↗
PubMed1980

Nummular keratitis associated with infectious mononucleosis.

A 16-year-old boy had a severe case of infectious mononucleosis with a rising titer to the Epstein-Barr virus. The patient had developed a nummular keratitis apparently associated with this illness. Because infectious mononucleosis or infection by the Epstein-Barr virus is often subclinical, and many cases of nummular keratitis have been classified as idiopathic in the past, a possible association between the two in such cases should be considered.

Adolescent↗
PubMed1993

Risk of agranulocytosis and aplastic anemia in relation to history of infectious mononucleosis: a report from the international agranulocytosis and aplastic anemia study.

The general objective of this study was to evaluate the risks of agranulocytosis and aplastic anemia in relation to drug use. Other potential risk factors, including history of infectious mononucleosis, were also evaluated. In an international population-based case-control study, cases of agranulocytosis and aplastic anemia and controls, who were patients with selected diagnoses, were identified from the same hospitals. Information on drug use was obtained in a structured interview. Limited information on environmental exposures and on selected items of medical history, including infectious mononucleosis, was also recorded. The possible effects of these factors on the risk of the two blood dyscrasias were evaluated. Relative risks were estimated by stratified analysis and by multiple logistic regression. Among 319 cases of agranulocytosis, 12 patients (4%) gave a history of infectious mononucleosis at least 1 year previously; among 2180 controls the corresponding number was 11 (0.5%) (multivariate relative risk estimate, 6.2; 95% confidence interval, 2.3-17). A nonsignificant elevation in the relative risk was observed for aplastic anemia. The data suggest that infectious mononucleosis may confer a long-term increase in the risk of agranulocytosis. However, the association was an unexpected one, identified in the course of multiple comparisons, and it must be independently confirmed.

Adolescent↗