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PubMed1980

Abnormalities of the pharynx and prevertebral soft tissues in infectious mononucleosis.

Four cases of infectious mononucleosis complicated by airway obstruction are reported. In each case, radiographs demonstrated marked enlargement of the adenoids, tonsils, the prevertebral cervical soft tissues, or a combination of two or three of these. These changes are associated with, and help to explain, severe dysphagia and dyspnea in some children with infectious mononucleosis. Occasionally, the diagnosis may be suggested from radiologic findings.

Adenoids↗
PubMed1990

Infectious mononucleosis in older adults.

Infectious mononucleosis as a manifestation of primary Epstein-Barr virus infection occurs uncommonly in adults over age 40. While fever is almost universal, older patients with the disease often present without lymphadenopathy, pharyngitis, splenomegaly, lymphocytosis or atypical lymphocytes. Jaundice and hepatomegaly occur more commonly in older patients than in adolescents and create diagnostic confusion. Often, infectious mononucleosis in this age group is confused with lymphoma, leukemia or biliary obstruction, or is classified as "fever of unknown origin."

Adult↗
PubMed2004

Infectious mononucleosis: return to play.

Infectious mononucleosis most commonly affects adolescents and young adults with a febrile illness accompanied by pharyngitis,lymph node enlargement, and transient fatigue. The diagnosis is usually confirmed with demonstration of heterophile antibodies. Typical signs and symptoms are reviewed, along with pitfalls in diagnosis and management. The rare complication of splenic rupture serves to focus recommendations for returning athletes to strenuous physical activities. Because careful prospective studies of infectious mononucleosis in athletes are lacking, review of available literature suggests that clinicians may recommend a return to all sports in those without spleen enlargement 4 weeks after the onset of illness.

Humans↗
PubMed1982

Spurious rapid infections mononucleosis test results in non-infectious mononucleosis sera. The role of high-titer horse agglutinins.

The present report-describes serologic data from five individuals without infectious mononucleosis (IM) who had very high levels of horse red blood cell agglutinins (1:896-1:7168) that were unusual in that they were minimally absorbed by either guinea pig kidney or beef red blood cell suspensions. Agglutination of sheep red blood cells was negative, and Epstein-Barr virus (EBV)-specific serodiagnostic tests revealed evidence for long past primary infections. In one of the five cases, serologic findings suggested a more than usually active EBV carrier state, as evident from persistently high anti-VCA (IgG) levels of 1:1280 and the continual presence of anti-R at 1:40. Sera from all cases predictably interfered with several commercially available IM-specific rapid slide agglutination tests. The incidence of such findings was estimated to be no more than one per one thousand non-IM cases. In three patients adequately studied, the poorly absorbable horse agglutinins persisted in serum samples over periods of five to nine years. The significance of these findings is discussed.

Adult↗
PubMed2001

[Levels of soluble intracellular adhesion molecules 1 (sICAM-1) , soluble receptors for interleukin 2 (sIL-2R) and anti-Epstein-Barr viral capsid antigen (anti-VCA IgM) in blood serum during the course of infectious mononucleosis].

The clinical picture of infectious mononucleosis and the consequences of EBV infection are due to immune response mechanisms. The level of soluble form of IL-2 receptor (sIL-2R) is thought to be a marker of T-cell activity, especially CD8+. Intercellular adhesion molecule (ICAM-1, CD 54) plays an important role in the process of antigen presentation. The aim of this study was to assess the serum concentration of sIL-2R, ICAM-1 and anti-VCA IgM in patients with infectious mononucleosis. The study group comprised 42 persons: 20 healthy subjects as a control group and 22 individuals with infectious mononucleosis. The highest anti-VCA IgM serum level in all patients was during the 1st day of hospitalization, and decreased in the 8th day of hospitalization. The lowest antibody concentration was observed when the symptoms and sings ceased. The level of sIL-2R was significantly increased and during farther hospitalization we observed lower, but still elevated concentrations. Our study has demonstrated statistically significant elevation of sICAM-1 level during the entire period of hospitalization. This data indicates the importance of antigen presentation process. Although the serum concentration of immune response mediators does not reflect their contents in organism, but is a useful method for in vivo examination.

Adult↗
PubMed1977

[T- and B-lymphocyte determination in infectious mononucleosis].

In 12 children with infectious mononucleosis the peripheral blood T- and B-lymphocytes were studied and compared to a control group of 26 children, aged 2 to 13 years, without any infection. Spontaneous sheep red blood cell rosettes were used as a T-cell marker, demonstration of surface immunoglobulins by immunofluorescence technique was used as a B-cell marker. Patients with infectious mononucleosis showed a marked increase of T-lymphocytes (percentage and absolute numbers) in comparison with the control group; the difference was statistically significant. Since only B-lymphocytes are the target cells fo Epstein-Barr virus, the increase of T-lymphocytes in infectious mononucleosis probably represents the response of cell mediated immunity against B-lymphocytes which are altered in their antigenic properties by Epstein-Barr virus.

Adolescent↗
PubMedDate not supplied

Infectious mononucleosis preceding acute myelomonocytic leukemia.

The patient discussed in this report had acute myelomonocytic leukemia (AMML) associated with infectious mononucleosis. Infectious mononucleosis (IM) in association with acute leukemia (AL) has provided clinical investigators an active area of speculation for several years. Nineteen cases are presented for review in Table 1. The present case represents the second case of AMML to be associated with IM. It is the first case of a granulocytic leukemia reported in which active IM is occurring simultaneously with the onset of AL. Also, it represents the first case of associated IM-AL in which the diagnosis of IM is supported by lymphocyte culture data. This may represent a mechanism for additional investigation in future cases.

Acute Disease↗
PubMed1987

Hepatitis in fatal infectious mononucleosis.

A detailed clinicopathologic analysis of 30 patients with sporadic fatal infectious mononucleosis and 31 males with fatal infectious mononucleosis and the X-linked lymphoproliferative syndrome was performed to determine the extent of hepatic dysfunction in these cases. At death, the median age of patients with sporadic infectious mononucleosis was 10.7 yr vs. 2.4 yr for X-linked lymphoproliferative syndrome. The median survival time was 8 wk for sporadic infectious mononucleosis and only 4 wk for X-linked lymphoproliferative syndrome. The male to female ratio was 3:2 in sporadic infectious mononucleosis; all patients with X-linked lymphoproliferative syndrome were males. Fever, sore throat, lymphadenopathy, hepatomegaly, and splenomegaly were prominent findings. Hepatic dysfunction was uniformly present and caused death in 13 of 30 sporadic infectious mononucleosis cases and 18 of 31 X-linked lymphoproliferative syndrome cases. Diagnosis of infectious mononucleosis was confirmed by heterophile antibody titers or Monospot, Epstein-Barr virus antibody studies, viral culture, molecular hybridization studies, clinical and histologic findings, and pedigree analysis.

Child↗
PubMed1965

BIOCHEMICAL STUDIES ON HEPATIC INVOLVEMENT IN INFECTIOUS MONONUCLEOSIS.

Eighty cases of infectious mononucleosis have been investigated by serum enzyme studies and other liver function tests. Maximum abnormalities occurred between the second and fourth weeks of illness and all tests were usually normal by the sixth week. Serum isocitric dehydrogenase activity was increased in 93% of cases and serum glutamic-oxaloacetic transaminase in 74%. Conventional liver function tests were less sensitive. Serum bilirubin was above normal in 40% of cases; in 17% of cases the increase was sufficient to show as clinical jaundice. No patient has developed chronic hepatitis.

Alanine Transaminase↗
PubMed1993

Infectious mononucleosis presenting as erythema multiforme.

Infectious mononucleosis is rarely associated with skin lesions. A 23-year-old woman with acute infectious mononucleosis who presented with moderately severe erythema multiforme is reported. The role of steroids in the management of this condition is briefly discussed.

Adult↗
PubMed1989

[Acute tonsillectomy in infectious mononucleosis].

Enlargement of the pharyngeal tonsils in infectious mononucleosis (MI) is frequently an important component of the clinical picture but pronounced obstruction of the upper respiratory passages is rare. An analysis of 11 cases of infectious mononucleosis with varying degrees of pharyngeal obstruction is presented. During the acute phase of the disease, tonsillectomy was performed and also adenoidectomy in four of the cases. The patients improved rapidly after the operation and were discharged after an average of four days. No noteworthy complications of the operation occurred. An unexpectedly great number of cases of abscess formation were found at operation. Histological examination of the tonsils revealed changes in the lymphoid tissue which were characteristic but not specific for infectious mononucleosis together with extensive necrosis of the tonsillar surface. On the basis of this investigation, the authors consider that acute tonsillectomy is indicated in infectious mononucleosis with threatening occlusion of the upper airway and in cases of suspected peritonsillar abscess. In cases of slight or moderate respiratory obstruction, acute tonsillectomy may be considered in the therapeutic deliberations if the course of the condition is protracted and steroid treatment does not have the desired effect.

Adenoidectomy↗