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PubMed1994

Diagnosis and treatment of infectious mononucleosis.

Infectious mononucleosis is caused by the Epstein-Barr virus (EBV) and most commonly affects young adults from 15 to 35 years of age. The diagnosis is made by accurate assessment of clinical, hematologic and serologic manifestations of the illness. Manifestations include the classic triad of fever, pharyngitis and cervical lymphadenopathy; lymphocytosis with a predominance of atypical lymphocytes; a positive heterophil (Monospot) antibody test; and in some cases, serologic evidence of EBV-specific antibodies produced against antigens related to the virus. The most valuable serologic finding is the presence of IgM antibody to EBV viral capsid antigen, which is found during acute primary EBV infection. Infectious mononucleosis is considered a self-limited illness, but it may result in serious complications involving the pulmonary, ophthalmologic, neurologic and hematologic systems. Treatment is focused on managing the symptoms, unless more severe disease involving other organ systems occurs. The most common potentially fatal complication is splenic rupture.

Convalescence↗
PubMed2001

Infectious mononucleosis.

Infectious mononucleosis in its classical presentation consists of the clinical triad of fever, pharyngitis, and cervical lymphadenopathy. The majority of cases are caused by primary infection with the Epstein-Barr virus (EBV). There is, however, a wide clinical spectrum of disease manifestations, including pulmonary, hematologic, and neurologic findings and a series of associated laboratory abnormalities, such as lymphocytosis, heterophile antibodies, and anti-EBV antibodies. The disease is typically self-limited and treated with supportive therapy only. Rarely, serious complications such as airway obstruction, severe thrombocytopenia, or severe hemolytic anemia can occur. Infectious mononucleosis does not cause congenital anomalies, and pregnant women are not at increased risk of serious complications resulting from the disorder.

Journal Article↗
PubMedDate not supplied

Abdominal complications of infectious mononucleosis.

Infectious mononucleosis, a systemic illness caused by the Epstein-Barr virus, is seen frequently by primary care physicians. Mononucleosis affects several organ systems, and, within the abdomen, there can be splenic involvement, hepatitis, mesenteric lymphadenopathy, hyperplasia of gut-associated lymphoid tissue, pancreatitis, and transient malabsorption. Life-threatening abdominal complications require prompt recognition and intervention. Other abdominal complications, though worrisome, are usually short-lived and resolve without sequelae.

Hepatitis↗
PubMed1975

Life-threatening complications of infectious mononucleosis.

Infectious mononucleosis is a common febrile disorder of children and young adults which is generally benign and self-limited. Patients with this disorder, however, may develop life-threatening complications which require prompt recognition and treatment. The clinical features of three such cases are presented and pertinent features of other life-threatening complications are reviewed.

Adolescent↗
PubMed1978

Psychiatric and neurologic sequelae of infectious mononucleosis.

Infectious mononucleosis is usually thought to be a benign disease with occasional neurologic sequelae. Depression, incoordination, a reduction in intellectual ability, and altered EEG patterns were found in two patients; one recovered and the other seemed to have permanent residual effects. The possibility of tranylcypromine as a treatment for the depression and appropriate counselling of patient and family are discussed.

Adolescent↗
PubMed1983

[Isolated abducent nerve paralysis in infectious mononucleosis].

Infectious mononucleosis in children and adolescents is characterized by a large variability of symptoms and clinical course. Serological tests for Epstein-Barr-Virusspecific antibodies are a valuable aid in differential diagnosis, in particular for pediatricians. - Isolated palsy of the abducens nerve is reported in a 12-year-old girl. The parainfectious etiology of this mononeuritis was determined only by specific serological tests.

Abducens Nerve↗
PubMed1998

Sudden asphyxial death complicating infectious mononucleosis.

Infectious mononucleosis (IM) is a disease traditionally defined by a triad of clinical, laboratory, and serologic factors. It is typically a benign, self-limited disease of children and young adults. Upper airway obstruction is a rare but potentially fatal complication of IM resulting from massive tonsillar enlargement, pharyngeal edema, or both. We report a case of sudden death due to airway obstruction in IM.

Adolescent↗
PubMed2004

Electron microscopic characteristics of peripheral blood lymphocytes in children with infectious mononucleosis.

Infectious mononucleosis is associated with pronounced changes in surface architectonics of peripheral blood lymphocytes persisting during convalescence and remote period after the disease. The degree of these changes depends on the disease agent and age-specific characteristics of the body. The most pronounced and sustained disorders in the morphostructural organization of lymphocytes are caused by Epstein-Barr virus (in comparison with agents of other etiology); these disorders are more pronounced in children aged 7-14 years than in those aged 3-6 years.

Adolescent↗
PubMed1976

Diagnosis of infectious mononucleosis.

Infectious mononucleosis continues to be an important medical problem of young adults. Diagnosis is based on three principal criteria: (1) a compatible clinical picture, (2) characteristic hematologic changes, and (3) a positive serology. A relative lymphocytosis of 60% or higher with at least 20% atypical lymphocytes is a common feature. Laboratory diagnosis is dependent on proper application and interpretation of the various serologic tests. Evidence of abnormal liver function is of particular value in differentiating this disease from bacterial and viral pharyngitis.

Adolescent↗
PubMed1983

Beta-hemolytic streptococcal pharyngitis: uncommon in infectious mononucleosis.

Infectious mononucleosis (IM) and beta-hemolytic streptococcal pharyngitis may present similar clinical pictures and may occur concurrently; however, recent studies have differed sharply with older ones that cited high rates of concurrent disease. Our study of 100 consecutive new patients meeting strict criteria for a diagnosis of IM found only 4% with positive throat cultures for group A beta-hemolytic streptococci at the time of diagnosis. Use of antibiotics for presumed streptococcal pharyngitis in patients with IM is unjustified. Only patients with positive cultures should be treated.

Adolescent↗
PubMed1989

Recent advances on Epstein-Barr virus infectious mononucleosis.

Infectious mononucleosis (IM) is an acute, self-limited lymphoproliferative disorder caused by EBV. The classic features consist of fever, malaise, easy fatigability, pharyngotonsillitis, cervical lymphadenopathy, splenomegaly, subclinical hepatitis, and atypical lymphocytosis. Symptomatic IM occurs in older children and adolescents, whereas the subclinical IM is the rule in toddlers and young children. In general the prognosis is good, even in the more prolonged and serious cases. The laboratory diagnosis relies on the demonstration of heterophil antibody in the serum. Since there is no effective therapy, management is directed toward relief of symptoms and treatment of complications. No effective ways of prevention are at hand.

Herpesvirus 4, Human↗
PubMed1982

Pulmonary function in infectious mononucleosis.

Infectious mononucleosis (IM) is common among students. These patients often complain of fatigue and dyspnea. To determine whether IM alters respiratory function, we performed spirometric, single-breath diffusing capacity, and maximal static respiratory pressure tests on seven patients with symptoms of IM. These studies were repeated two weeks later and the respiratory pressures were repeated five months later. Each patient served as his own control. Pulmonary function was normal except for respiratory pressures, which were initially low. These pressures, still low after two weeks, improved significantly after five months. We concluded that IM is associated with transient respiratory muscle weakness.

Adolescent↗
PubMed2003

[Infectious mononucleosis].

Infectious mononucleosis (IM) is the manifestation of primary infection with Epstein-Barr virus (EBV). EBV persisting after infection for a life-time infects > 90% of the adult population. Primary infection mostly asymptomatic in young children manifests in teenagers and young adults in about 50% as IM with fever, sore throat, generalized lymphadenopathy, frequently hepatosplenomegaly and blood lymphocytosis with the characteristic atypical lymphocytes. Clinical presentation, typical lymphocytosis and heterophile antibodies are diagnostic. Atypical cases may need to be confirmed by specific serology. IM is a self-limiting lymphoproliferation regressing within 2-3 weeks. Complications are rare and may involve many different organs. Severe cases are very uncommon, except in patients with inborn or acquired immunodeficiency carrying a substantially higher risk for severe courses, pogredient lymphoproliferation and lymphoma.

Adolescent↗
PubMed2004

Massive retropharyngeal lymphadenopathy in an infant: an unusual presentation of infectious mononucleosis.

Infectious mononucleosis causing upper airway obstruction due to tonsillar disease and associated lymphadenopathy in adolescents is well recognized. However, infection with Epstein-Barr virus (EBV) in a young child of six months is rare. The authors present such a case, with massive swelling of the retropharyngeal lymph nodes, that has not been published previously. The patient presented to this department with a short history of an upper respiratory tract infection and mild upper airway obstruction. On examination there was a massive enlargement of the retropharyngeal space with a compromised airway. This was confirmed on X-ray. She made an uneventful recovery following incision and drainage and a short period of endotracheal intubation. Because of the presence of retropharyngeal lymphoid tissue in infancy an alternative site of upper airway obstruction may occur here in this age group.

Airway Obstruction↗
PubMed1988

Comparative evaluation of three commercial tests for detection of heterophile antibody in patients with infectious mononucleosis.

Infectious mononucleosis (IM) is caused by the Epstein-Barr virus. Commonly used laboratory tests used for diagnosis of IM include a screening test based on the observation that horse erythrocytes are agglutinated by the Paul-Bunnell antibody found in the serum of patients with IM. This study evaluated two latex agglutination (LA) kits for IM, Monolatex (Wampole Laboratories) and Immunoscan-IM (American MicroScan) (formerly Monogen; Biokit, S.A.), and compared them with Monospot (Ortho Diagnostic Systems) results on 220 patient sera. Discrepancies in the three test results were resolved with complete Epstein-Barr virus antibody profiles. They indicated that any of the three kits tested can be successfully used as a screening test for IM. The advantage of the LA kits is that no differential absorption step is necessary. When discrepancies were resolved, sensitivity and specificity of both LA kits were greater than 93%.

Adolescent↗
PubMed2004

Biology of Epstein-Barr virus during infectious mononucleosis.

Infectious mononucleosis is the clinical manifestation of primary infection with Epstein-Barr virus (EBV). We monitored primary infection during convalescence and during the establishment of persistent infection. The profiles of EBV strains in the oral cavity and in peripheral blood were determined by use of a heteroduplex tracking assay specific for the EBV gene encoding latent membrane protein 1. Multiple EBV strains were detected in most patients and persisted in and were possibly transmitted among 3 distinct compartments of infection, including the oral cavity, peripheral blood lymphocytes, and the cell-free fraction of the blood plasma. We also tracked transmission of multiple strains from an asymptomatic carrier to a patient diagnosed with primary EBV infection. These data reveal that primary EBV infection is complex, with transmission of multiple strains and clear differences in relative abundance of strains in distinct compartments.

Adolescent↗