Journal articles on the topic 'Infectious mononucleosis (IM)'
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Skulnick, Martin, Donald E. Low, Andrew E. Simor, Mohan Patel, Pauline George, and Robert Chua. "Comparative Evaluation of Seven Commercial Tests for Detection of Heterophile Antibody in Infectious Mononucleosis." Canadian Journal of Infectious Diseases 3, no. 1 (1992): 23–26. http://dx.doi.org/10.1155/1992/510261.
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Detection of heterophile antibodies in infectious mononucleosis is the most rapid and cost-effective method for confirming the clinical diagnosis of the disease. This study compared seven commercial test kits (the Oxoid Infectious Mononucleosis Kit [Oxoid Ltd], Immunoscan Im-Latex [Baxter Travenol], Mono-Latex [Wampole Laboratories], Monospot and Im Screen Test [Ortho Diagnostics], Immunoscan Im-RBC Test [Baxter Travenol], and Infectious Mononucleosis Test [NCS Diagnostics]) to the Davidsohn differential test. All of the kits were shown to be acceptable for use, with specificities and sensitivities greater than 96.5% and 95.5%, respectively.
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Zaadstra, BM, AMJ Chorus, S. van Buuren, H. Kalsbeek, and JM van Noort. "Selective association of multiple sclerosis with infectious mononucleosis." Multiple Sclerosis Journal 14, no. 3 (April 2008): 307–13. http://dx.doi.org/10.1177/1352458507084265.
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Previous studies have suggested an association between multiple sclerosis (MS) and infectious mononucleosis (IM) but data on the exact strength of this association or its selectivity have been conflicting. In this study we have evaluated the association between MS and a variety of common childhood infections and afflictions in a large population-based case-control study involving 2877 MS cases and 2673 controls in the Netherlands. We examined the frequency of different common infections and afflictions before the age of 25 and the age at which they occurred, using a self-administered questionnaire. The Odds ratios (ORs) for the occurrence of a variety of clinically manifest common childhood infections including rubella, measles, chicken pox and mumps before the age of 25 for MS cases versus controls ranged between 1.14 and 1.42, values similar to those for irrelevant probe variables used to reveal recall bias. In contrast, the OR for clinically manifest IM in MS cases versus controls, corrected for demographic variables, was 2.22 (95% confidence interval 1.73 — 2.86; P < 0.001). The average age of onset of IM in the population of MS cases (16.5 years) did not differ from controls (16.8 years). Our data confirm previous much smaller studies to show that the risk for MS is significantly enhanced by prior IM, and extend those previous data by showing that this association is far stronger than with other common childhood infections or afflictions. Multiple scelerosis 2008; 14: 307—313. http://msj.sagepub.com
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Odalovic, Bozidar, Milan Jovanovic, Radojica Stolic, Branislav Belic, Simon Nikolic, and Predrag Mandic. "Spontaneous splenic rupture in infectious mononucleosis." Srpski arhiv za celokupno lekarstvo 146, no. 5-6 (2018): 320–22. http://dx.doi.org/10.2298/sarh160629207o.
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Introduction. Spontaneous splenic rupture is a rare but potentially fatal complication of infectious mononucleosis (IM). It occurs in only 0.1?0.5% of cases of this disease. The aim of this paper was to present a case with spontaneous splenic rupture after IM. Case outline. A 22-year-old female patient was feeling better one month after she was treated for infectious mononucleosis, and started training volleyball. Two weeks after starting the training, she felt severe abdominal pain. The diagnosis of rupture was confirmed with computer tomography. Splenectomy was successfully performed. The postoperative course was uneventful and the patient recovered with no need for blood transfusion. Conclusion. Timely diagnosis and setting indications for surgical treatment are crucial in healing. Patients should wait to start with sport activities at least two months if the size of the spleen is within normal range.
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Odame, John, Joan Robinson, Nasser Khodai-Booran, Simon Yeung, Tony Mazzulli, Derek Stephens, and Upton D. Allen. "Correlates of Illness Severity in Infectious Mononucleosis." Canadian Journal of Infectious Diseases and Medical Microbiology 25, no. 5 (2014): 277–80. http://dx.doi.org/10.1155/2014/514164.
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INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV) complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses.OBJECTIVES:To determine the clinical and laboratory correlates of illness severity among infants, children and youth with infectious mononucleosis (IM).METHODS: Study subjects with confirmed IM were prospectively enrolled. Illness severity was assessed at baseline and at six weeks using a scoring tool. Peripheral blood viral loads served as a measure of viral burden.RESULTS: Among 32 children and young adults with IM, the median age was 16 years (range two to 24 years). The predominant clinical findings were lymphadenopathy (23 of 32 [72%]), pharyngitis (16 of 32 [50%]), fever (nine of 32 [28%]) and splenomegaly (six of 32 [19%]). With respect to symptoms or signs that persisted to at least six weeks after illness onset, the predominant complaint was lymphadenopathy in 35% of subjects available for reassessment. Deranged liver function tests were present at presentation in up to 44% of subjects. Patients with the highest viral loads at presentation had significantly higher illness severity scores associated with fatigue (P=0.02). Other than the scores associated with fatigue, viral load values were not significantly correlated with the illness severity scores at baseline and at six weeks.CONCLUSION: In IM, viral loads are not necessarily correlated with illness severity, with the exception of fatigue. EBV-related hepatitis is common in IM, confirming the status of this virus as a relatively common cause of transient hepatitis in children and youth. This entity is not necessarily a marker of disease severity.
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Apriasari, Maharani Laillyza. "Methisoprinol as an immunomodulator for treating infectious mononucleosis." Dental Journal (Majalah Kedokteran Gigi) 49, no. 1 (December 5, 2016): 1. http://dx.doi.org/10.20473/j.djmkg.v49.i1.p1-4.
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Background: Infectious mononucleosis (IM) is the self limiting disease that associated with primary Epstein Barr virus (EBV). It is a gamma herpes virus. EBV infection is follows saliva-transfer by kissing or sexual intercourse. The most clinical manifestation in IM consists mainly of the specific sign: pharyngitis, fever, and lymphadenopathy. The main therapy is supportive treatment. Actually the antiviral therapy is required for the host with high response immune. Purpose: The aimed of this study was to report the therapy of IM using methisoprinol. Case: The woman patient, 33 years old, came to hospital by suffering pharyngitis and swolen on left neck. It had been since 3 days ago. Case management: She had come to Puskesmas that were given amoxycillin capsul 500 mg three times a day for three days and paracetamol tablet 500mg three times a day for three days, but she was still ill. Then she came to RSGM Hasan Aman Banjarmasin. She was diagnosed as IM. The instruction were isolation and bed rest for a week. She had to eat sofly and drink water highly. The therapy were amoxycillin capsul 500 mg three times a day for seven days, methisoprinol caplet 500 mg three times a day for seven days, natrium dikofenak tablet 50 mg three times a day for seven days. She was asked to see the dentist next 7 days. In this case, she were not given acyclovir. Conclusion: IM is self limiting disease. IM is the disease with spesific clinical syndrome that associated with primary EBV infection. Depend on the base of clinical experiences, the supportive treatment is adviced for patient of IM. Methisoprinol has both immunomodulator and antiviral properties.
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Foss, HD, H. Herbst, M. Hummel, I. Araujo, U. Latza, C. Rancso, F. Dallenbach, and H. Stein. "Patterns of cytokine gene expression in infectious mononucleosis." Blood 83, no. 3 (February 1, 1994): 707–12. http://dx.doi.org/10.1182/blood.v83.3.707.707.
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Abstract Primary infection with Epstein-Barr virus (EBV) may arise as infectious mononucleosis (IM) in adolescents and young adults. Morphologically, IM- affected lymphoid tissue is characterized by expanded interfollicular areas with formation of atypical lymphoid blasts. It is assumed that morphology and clinical presentation of IM are related to characteristic patterns of cytokine production by EBV-infected and reactive cells. We studied IM tonsils of eight patients and six normal tonsils with a double in situ hybridization procedure using [35S]- labeled RNA probes specific for various cytokines and digoxigenin- labeled probes for the detection of the nuclear EBV encoded RNA transcripts, EBER 1 and 2. All of the IM cases displayed the same distinct cytokine gene expression pattern. When compared with interfollicular areas of normal tonsils, expression of lymphotoxin (LT), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and IL-1 beta, but not IL-8 or IL-1 alpha was strongly enhanced in interfollicular areas in IM tonsils. LT was expressed predominantly by EBV-infected cells. TNF-alpha transcripts were also present in EBV- infected cells, although in smaller proportions. IL-6 specific signals were only found in few EBV-infected cells. IL-1 alpha-, IL-1 beta-, and IL-8-specific signals were not observed in EBV-infected cells, but were present at high signal intensity in many cells within and around foci of EBV-infected cells (IL-1 beta), next to areas of necrosis (IL-8, IL- 1 beta), or in epithelial cells (IL-1 alpha). These data suggest that EBV infection in form of IM results in induction of specific sets of cytokine genes in EBV-infected and in neighboring EBV-negative cells contributing to the characteristic morphology and cellular arrangement of the lesion as well as the clinical presentation.
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Foss, HD, H. Herbst, M. Hummel, I. Araujo, U. Latza, C. Rancso, F. Dallenbach, and H. Stein. "Patterns of cytokine gene expression in infectious mononucleosis." Blood 83, no. 3 (February 1, 1994): 707–12. http://dx.doi.org/10.1182/blood.v83.3.707.bloodjournal833707.
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Primary infection with Epstein-Barr virus (EBV) may arise as infectious mononucleosis (IM) in adolescents and young adults. Morphologically, IM- affected lymphoid tissue is characterized by expanded interfollicular areas with formation of atypical lymphoid blasts. It is assumed that morphology and clinical presentation of IM are related to characteristic patterns of cytokine production by EBV-infected and reactive cells. We studied IM tonsils of eight patients and six normal tonsils with a double in situ hybridization procedure using [35S]- labeled RNA probes specific for various cytokines and digoxigenin- labeled probes for the detection of the nuclear EBV encoded RNA transcripts, EBER 1 and 2. All of the IM cases displayed the same distinct cytokine gene expression pattern. When compared with interfollicular areas of normal tonsils, expression of lymphotoxin (LT), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and IL-1 beta, but not IL-8 or IL-1 alpha was strongly enhanced in interfollicular areas in IM tonsils. LT was expressed predominantly by EBV-infected cells. TNF-alpha transcripts were also present in EBV- infected cells, although in smaller proportions. IL-6 specific signals were only found in few EBV-infected cells. IL-1 alpha-, IL-1 beta-, and IL-8-specific signals were not observed in EBV-infected cells, but were present at high signal intensity in many cells within and around foci of EBV-infected cells (IL-1 beta), next to areas of necrosis (IL-8, IL- 1 beta), or in epithelial cells (IL-1 alpha). These data suggest that EBV infection in form of IM results in induction of specific sets of cytokine genes in EBV-infected and in neighboring EBV-negative cells contributing to the characteristic morphology and cellular arrangement of the lesion as well as the clinical presentation.
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Hanna, Brendan C., Ronan McMullan, and Samuel J. Hall. "Corticosteroids and peritonsillar abscess formation in infectious mononucleosis." Journal of Laryngology & Otology 118, no. 6 (June 2004): 459–61. http://dx.doi.org/10.1258/002221504323219608.
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Peritonsillar abscess formation is an uncommon complication of infectious mononucleosis (IM). Early case reports implicated corticosteroids in the development of such abscesses, however, subsequent studies suggested that these drugs do not promote the formation of abscesses at several sites outside the central nervous system. It has recently been demonstrated that zwitterionic polysaccharides, in bacterial capsules, form complexes with CD4+ T lymphocytes leading to abscess formation. A patient is presented who developed peritonsillar abscess a few days after initiation of corticosteroid therapy for IM; the medical literature was reviewed in respect of this subject. It appears that the occurrence of these abscesses in IM is not strongly linked to corticosteroid treatment. The authors, therefore, recommend that steroids should not be withheld from patients with severe IM on the basis that they may precipitate the development of peritonsillar abscess.
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Stevenson, D. S., G. Webster, and I. A. Stewart. "Acute tonsillectomy in the management of infectious mononucleosis." Journal of Laryngology & Otology 106, no. 11 (November 1992): 989–91. http://dx.doi.org/10.1017/s0022215100121541.
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AbstractLife-threatening upper airway obstruction can be caused by tonsillopharyngitis secondary to infectious mononucleosis (IM). The administration of corticosteroids, emergency tracheostomy and acute tonsillectomy have been advocated as ways of managing this problem. In a series of 25 patients admitted over a five-year period with IM, 15 were judged to have symptoms severe enough to warrant the administration of corticosteroids. Six of these 15 patients had little improvement in their condition and thus underwent acute tonsillectomy. There were no significant complications of this surgery. A further three patients who received corticosteroids required tonsillectomy for recurrent tonsillitis later in the study period. By contrast, only one of the ten patients who did not receive corticosteroids subsequently required tonsillectomy. Acute tonsillectomy is of value in selected cases of IM tonsillopharyngitis. It may decrease the morbidity of recurrent tonsillitis after IM, in addition to averting the immediate risk of respiratory obstruction.
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Trisko, A. A., Marina G. Avdeeva, and N. V. Kolesnikova. "Clinical and immunological peculiarity of acute Epstein-Barr virus infection in adults." Epidemiology and Infectious Diseases 21, no. 3 (June 15, 2016): 130–35. http://dx.doi.org/10.17816/eid40908.
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The goal - improving the quality of the diagnosis of acute infectious mononucleosis (IM) in adults on the basis of a comparative study of cytokine status in MI, acute tonsillitis and acute viral hepatitis. Materials and methods. We observed three groups of patients hospitalized in «Specialized Clinical Hospital of Infectious Diseases of the Ministry of Health of the Krasnodar Territory» in 2012-2014: 29 patients with myocardial infarction (group 1), 25 - with acute tonsillitis (group 2), 19 - with acute viral hepatitis (group 3) and the control group. The groups were matched by sex, age and severity of the disease. In the acute phase of the disease the level of cytokines IL-1a, IL-1β, RaIL-1, IL-4, INF-y in serum was studied by ELISA. Results. At the height of the infectious mononucleosis increased content of IL-1a, IL-1β and INF-y was observed. In acute viral hepatitis significant increase in IL-1β, a less pronounced increase in INF-y, and no increase in IL-1a were registered. Acute tonsillitis is characterized by no increase in IL-1a and smaller increase in INF-y, compared to infectious mononucleosis. Significant difference between infectious mononucleosis and acute tonsillitis was a considerable rise of IL-1a and INF-y in first case. Acute viral hepatitis differs from infectious mononucleosis with pronounced increase in IL-1β. Conclusion. Determined significant intergroup cytokine status differences in patients with infectious mononucleosis, acute tonsillitis, and acute viral hepatitis may be helpful as additional diagnostic criteria for well examined infections in adults.
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Thompson, Dennis F., and Carroll L. Ramos. "Antibiotic-Induced Rash in Patients With Infectious Mononucleosis." Annals of Pharmacotherapy 51, no. 2 (October 1, 2016): 154–62. http://dx.doi.org/10.1177/1060028016669525.
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Objective: To provide an extensive review of case reports, epidemiological data, and the underlying mechanism of antibiotic-induced skin rash in patients with concurrent infectious mononucleosis (IM). Data Sources: A MEDLINE literature search inclusive of the dates 1946 to June 2016 was performed using the search terms anti-bacterial agents and infectious mononucleosis. EMBASE (1980 to June 2016) was searched using the terms mononucleosis and antibiotic agent and drug eruption. References of all relevant articles were reviewed for additional citations and information. Study Selection and Data Extraction: We selected English-language, primary literature, review articles, and mechanistic articles that addressed antibiotic-induced skin rash in patients with concurrent IM. We assessed all case reports available for causality utilizing a modified Naranjo nomogram specifically designed for this subject. We assembled the available epidemiological data into tables to identify trends in incidence rates over the years. Data Synthesis: We identified 17 case reports of antibiotic-associated rash in patients with IM. The median Naranjo score was 6 (range = 1 to 8). The top 3 reported drugs were ampicillin, azithromycin, and amoxicillin. Incidence of this adverse effect was higher in the 1960s (55.6%, 45%, and 33%) than in 2013 (33% and 15%). The mechanism most commonly proposed is a transient virus-mediated immune alteration that sets the stage for loss of antigenic tolerance and the development of a reversible, delayed-type hypersensitivity reaction to the antibiotic. Conclusion: A reassessment of the long-held belief of the high incidence (80%-100%) of antibiotic-induced skin rash in patients with IM seems prudent. Additional studies will be necessary to clarify this issue.
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GOLDACRE, M. J., C. J. WOTTON, and D. G. R. YEATES. "Associations between infectious mononucleosis and cancer: record-linkage studies." Epidemiology and Infection 137, no. 5 (October 8, 2008): 672–80. http://dx.doi.org/10.1017/s0950268808001246.
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SUMMARYInfection with Epstein–Barr virus (EBV) followed by infectious mononucleosis (IM) is now considered to be a risk factor for Hodgkin's disease (HD). It is less clear whether EBV infection and IM are associated with an increased risk of cancer generally. We used a longstanding record-linkage dataset in Oxford (years 1963–1998), and a more recent record-linkage dataset covering England (1999–2005), to compare rate ratios for cancer between people admitted to hospital for IM and a reference cohort. In the Oxford cohort, there was an increased risk of subsequent HD [rate ratio (RR) 6·0, 95% confidence interval (CI) 2·4–12·5] but not of other cancers combined (RR 0·85, 95% CI 0·57–1·23). In the England cohort, there were increased risks of HD (RR 3·2, 95% CI 1·2–7·0), non-Hodgkin's lymphoma (RR 5·6, 95% CI 2·9–9·8), and oropharyngeal cancer (RR 5·4, 95% CI 1·1–16·2), but no significant overall risk of cancer when lymphomas were excluded (RR 1·01, 95% CI 0·71–1·41). We confirm an association between IM and lymphoma; but the risk, if any, of cancer more generally is likely to be small.
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Nielsen, TR, K. Rostgaard, J. Askling, R. Steffensen, A. Oturai, C. Jersild, N. Koch-Henriksen, PS Sørensen, and H. Hjalgrim. "Effects of infectious mononucleosis and HLA-DRB1*15 in multiple sclerosis." Multiple Sclerosis Journal 15, no. 4 (January 19, 2009): 431–36. http://dx.doi.org/10.1177/1352458508100037.
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Background Both human leukocyte antigen (HLA)-DRB1*15 and Epstein-Barr virus infection presenting as infectious mononucleosis (IM) are recognized as risk factors for multiple sclerosis (MS). However, their combined effect and possible interaction on MS risk is not known. Objective To assess the association between HLA-DRB1*15 and risk of MS in persons with and without IM. Methods We compared the prevalence of DRB1*15 in MS patients with ( n = 76) and without ( n = 1,836) IM with the corresponding distributions in blood donors with ( n = 62) and without ( n = 484) IM histories. This allowed us to estimate the relative risk of MS associated with DRB1*15 in the presence and absence, respectively, of previous IM. We then estimated the interaction between DRB1*15 and IM as the ratio of the two individual odds ratios. Results In IM-naïve individuals, DRB1*15 carried a 2.4-fold (95% confidence interval [CI], 2.0–3.0) increased MS risk. In contrast, among persons with IM history, DRB1*15 was associated with a 7.0-fold (95% CI, 3.3–15.4) increased MS risk. Thus, the MS risk conferred by HLA-DRB1*15 was 2.9 (95% CI, 1.3–6.5)-fold stronger in the presence than in the absence of IM. Combined with previous results, this result indicates that DRB1*15-positive persons with a history of IM may be at a 10.0-fold (95% CI, 6.0–17.9) increased risk of MS compared with persons who are DRB1*15 and IM-naïve. Conclusion DRB1*15 and IM may act in synergy causing MS.
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Lahat, Eliezer, Gideon Eshel, and Aharon Arlazoroff. "“Alice in Wonderland” Syndrome: A Manifestation of Infectious Mononucleosis in Children." Behavioural Neurology 4, no. 3 (1991): 163–66. http://dx.doi.org/10.1155/1991/143219.
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The association between “Alice in Wonderland” Syndrome (AWS) and infectious mononucleosis (IM) has been previously described in three patients. We describe two additional cases in children, where in one case, the visual symptoms of AWS appeared during the course of active IM and in the second, 2 weeks following a clinically mild, but serologically proven attack.
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Din-Lovinescu, Corina, and Howard Berg. "Cervical necrotising fasciitis: a rare complication of infectious mononucleosis." BMJ Case Reports 12, no. 3 (March 2019): e228172. http://dx.doi.org/10.1136/bcr-2018-228172.
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Cervical necrotising fasciitis (NF) is an aggressive polymicrobial infection of the subcutaneous tissues in the head and neck. We present a case of a healthy 19-year-old man who developed cervical and upper mediastinal NF after an initial presentation of infectious mononucleosis (IM). He was treated with broad-spectrum antibiotics in addition to incision and drainage of an anterior neck and upper mediastinal abscess. He progressed favourably after ten days of hospitalisation and was discharged home on intravenous antibiotics. This is a unique case of cervical NF as a sequelae of IM in a previously healthy paediatric patient.
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Demina, O. I., T. A. Chebotareva, L. N. Mazankova, V. B. Tetova, and O. N. Uchaeva. "Infectious mononucleosis in children: clinical and laboratory characteristics depending on the disease etiology and phase of infection." Infekcionnye bolezni 18, no. 3 (2020): 62–72. http://dx.doi.org/10.20953/1729-9225-2020-3-62-72.
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Objective. To assess the association between clinical and laboratory characteristics of infectious mononucleosis (IM) and disease etiology and phase of infection. Patients and methods. This prospective observational study was conducted at Z.A.Bashlyaeva Children's City Clinical Hospital, Moscow Healthcare Department and included 107 children with IM. Laboratory testing was performed at the Department of Virological Diagnostics, National Medical Research Center for Hematology, Ministry of Health of the Russian Federation. Results. IM is a polyetiologic disease. So far, researchers have failed to find a significant correlation between clinical manifestations of IM and its etiology and phase of infection. Patients with IM caused by primary monoinfection with Epstein–Barr virus (EBV) are at high risk of developing chronic EBV infection. Neutrophilia is a typical laboratory sign of IM during the acute phase of it. Conclusion. The improvement of IM diagnosis with a detailed evaluation of clinical and laboratory criteria, as well as risk assessment of unfavorable outcome are currently impossible without the identification of both disease etiology and phase of infection. Key words: human herpes virus VI, Epstein–Barr virus, children, infectious mononucleosis, cytomegalovirus
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CANDY, B., T. CHALDER, A. J. CLEARE, A. PEAKMAN, A. SKOWERA, S. WESSELY, J. WEINMAN, M. ZUCKERMAN, and M. HOTOPF. "Predictors of fatigue following the onset of infectious mononucleosis." Psychological Medicine 33, no. 5 (June 26, 2003): 847–55. http://dx.doi.org/10.1017/s0033291703007554.
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Background. Infectious mononucleosis (IM) is a risk factor for chronic fatigue. Reduced activity is the most consistent factor found to be associated with poor outcome following the onset of infectious mononucleosis. However, little is known about the biological mechanisms involved in the pathogenesis of chronic fatigue following IM and no study, so far, has examined the relation between certain illness beliefs and poor outcome. This study explored immunological, endocrine, behavioural and cognitive responses to the acute illness and assessed which components of these groups of risk factors predicted a chronic course.Method. Using a prospective cohort design, 71 primary care patients with IM were enrolled onto the study and interviewed. Their recovery was explored by postal questionnaire up to 1 year later.Results. In the univariate analysis, increased baseline levels of immune activation were associated with fatigue at baseline and 3 months. Cortisol levels were not associated with fatigue at any point. Using multivariate models of clinical and psychosocial baseline factors, severity of symptoms and illness perceptions were found to predict fatigue 3 months later. At 6 months, fatigue was best predicted by female gender and illness perceptions, and at 12 months by female gender and a symptoms–disability factor.Conclusions. In the multivariate analysis no factors were found to predict poor outcome at all time-points. Instead the pattern of predictors changed over time, partly but not completely consistent with our a priori predictions. Larger studies are needed to explore further the predictive nature of biopsychosocial factors in the pathogenesis of chronic fatigue related to IM. The psycho-behavioural predictors found in this study are amenable to intervention. Such interventions should be tested in randomized controlled trials.
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Ramagopalan, Sreeram V., Gavin Giovannoni, David G. Yeates, Valerie Seagroatt, and Michael J. Goldacre. "Sex ratio of infectious mononucleosis and possible relevance to multiple sclerosis." Multiple Sclerosis Journal 19, no. 3 (July 10, 2012): 359–61. http://dx.doi.org/10.1177/1352458512450627.
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Infectious mononucleosis (IM) is associated with the risk of developing multiple sclerosis (MS). Using databases of hospital admissions for England (1999–2005), we investigated the female-to-male ratios (FMRs) for admission to hospital for IM and MS stratified by age. Males were more frequently admitted for IM for all age groups apart from ages 10–14 (FMR 1.50; 95% confidence interval (CI) 1.36–1.64) and, borderline significantly, at ages 15–19 (FMR 1.03, 95% CI 0.99–1.08). This intriguing aspect of IM epidemiology in adolescence, the atypical female excess, may be linked to the sex ratio of MS, where females predominate from adolescence.
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Jason, Leonard A., Joseph Cotler, Mohammed F. Islam, Jacob Furst, and Ben Z. Katz. "Predictors for Developing Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome following Infectious Mononucleosis." Journal of Rehabilitation Therapy 4, no. 1 (February 21, 2022): 1–5. http://dx.doi.org/10.29245/2767-5122/2021/1.1129.
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Background: About 10% of individuals who contract infectious mononucleosis (IM) have symptoms 6 months later that meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Our study for the first time examined whether it is possible to predict who will develop ME/CFS following IM. Methods: We have reported on a prospectively recruited cohort of 4,501 college students, of which 238 (5.3%) developed IM. Those who developed IM were followed-up at six months to determine whether they recovered or met criteria for ME/CFS. The present study focuses on 48 students who after six months had a diagnosis of ME/CFS, and a matched control group of 58 students who had no further symptoms after their IM. All of these 106 students had data at baseline (at least 6 weeks prior to the development of IM), when experiencing IM, and 6 months following IM. Of those who did not recover from IM, there were two groups: 30 were classified as ME/CFS and 18 were classified as severe ME/CFS. We measured the results of 7 questionnaires, physical examination findings, the severity of mononucleosis and cytokine analyses at baseline (pre-illness) and at the time of IM. We examined predictors (e.g., pre-illness variables as well as variables at onset of IM) of those who developed ME/CFS and severe ME/CFS following IM. Results: From analyses using receiver operating characteristic statistics, the students who had had severe gastrointestinal symptoms of stomach pain, bloating, and an irritable bowel at baseline and who also had abnormally low levels of the immune markers IL-13 and/or IL-5 at baseline, as well as severe gastrointestinal symptoms when then contracted IM, were found to have a nearly 80% chance of having severe ME/CFS persisting six months following IM. Conclusions: Our findings are consistent with emerging literature that gastrointestinal distress and autonomic symptoms, along with several immune markers, may be implicated in the development of severe ME/CFS. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating illness affecting over a million people in the US1. Six months after having had Infectious Mononucleosis (IM), about 9-12% of individuals are diagnosed with this syndrome. For example, Hickie et al.2 showed an 11% rate of ME/CFS six months following acute infection with Epstein-Barr virus as well as following two other similar systemic infections. Katz et al.3 found similar outcomes following IM in youth. In a recent prospective, longitudinal study, university students were assessed prior to IM, at the time of IM, and at a six-month follow-up. Those who developed severe ME/CFS had differences in several pre-illness domains compared to those who recovered from IM without further symptoms4. In addition, Katz et al.5 found that the severity of IM was predictive of severe ME/CFS 6 months following IM. We have used these baseline pre-illness behavioral and immune data along with severity of IM data to predict who will develop severe ME/CFS six months following IM.
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Yurko, K. V., V. M. Kozko, N. F. Merkulova, and О. I. Моhylenets. "ESTIMATION OF EFFICIENCY OF VARIOUS SCHEMES OF THERAPY OF PATIENTS WITH INFECTIOUS MONONUCLEOSIS CAUSED BY EPSTEIN – BARR." Likarska sprava, no. 7-8 (December 31, 2019): 41–45. http://dx.doi.org/10.31640/jvd.7-8.2019(6).
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Background: Actuality of study of infectious mononucleosis (ІМ) is conditioned by high infected of population by the Epstein – Barr virus (EBV), specific virus affinity to the immunocompetent cells, lifelong virus persistence in an organism and often latent process. Methods: Research on the work topic was conducted at the Department of Infectious Diseases of Kharkiv National Medical University. A total of 45 patients with IM (26 men and 19 women) who were hospitalized at the Regional Clinical Hospital in 2018–2019 years were surveyed. The vast majority of patients with IM were young people aged from 18 to 25, of whom 597 % were students. Results: The clinical picture of infectious mononucleosis caused by the Epstein–Barr virus, mainly characterized by manifestations of hepatomegaly, lymphadenopathy, intoxication syndrome and nasopharyngeal tonsillitis. The efficacy of combined use of Valacyclovir and Nuclex in complex therapy of patients with infectious mononucleosis caused by Epstein – Barr virus (EBV) was studied. The use of such therapy was found to promotes regression of clinical symptoms, contribute to normalization of indices of clinical blood tests and lead to a decrease of the number of EVB's DNA copies in the blood serum or complete elimination of virus. Conclusions: Thus, evaluation of the effectiveness of the use of valacyclovir and nuclex in the complex therapy of patients with infectious mononucleosis caused by Epstein–Barr virus, indicates a more significant regression of clinical symptoms, significantly more pronounced positive impact on the indicators of clinical blood analysis and the number of copies of EBV DNA in blood serum than in the comparison group. Obtained results allowed to substantiate the use of complex therapy of valacyclovir and nuclex in patients with IM caused by EBV.
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Kovacevic, Gordana, Ivana Hrnjakovic-Cvjetkovic, Vesna Milosevic, Vera Jerant-Patic, Jelena Radovanov-Tadic, and Gordana Kozoderovic. "Significance of screening tests in diagnosis of infectious mononucleosis." Medical review 61, no. 9-10 (2008): 489–96. http://dx.doi.org/10.2298/mpns0810489k.
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The investigation included 91 patients in who an acute or previous EBV infection was established by ELISA test. All patients were also subjected to the Paul-Bunnell-Davidsohn test, while 20 patients were tested by the rapid screening test Clearview IM. The diagnosis of acute infective mononucleosis was in 61 patients (67%) confirmed by the Elisa test, and in 12 patients (19.67 %) by the Paul-Bunnell-Davidsohn test, while the rapid screening test Clearview IM demonstrated too low a detection of heterophile antibodies. The rapid screening test was not reliable. In 25% cases, the test was invalid, at early infection stages the rapid test failed to diagnose any case of the EBV virus infection. Paull-Bunell-Davidsohn was often negative, especially with young children. Therefore, priority should be given to virology tests based on the detection of specific antibodies to EBV antigen.
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Slepicheva, N. R., O. I. Urazova, V. V. Novitsky, and A. P. Pomogayeva. "Cytotoxic activity of peripheral blood lymphocytes in children with infectious mononucleosis." Bulletin of Siberian Medicine 8, no. 4 (August 28, 2009): 64–69. http://dx.doi.org/10.20538/1682-0363-2009-4-64-69.
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Twenty children aged 3—6 years with Epstein—Barr-virus-induced infectious mononucleosis (IM) were examined. The present study is aimed at investigating the functional activity of cytotoxic lymphocytes in children with IM during clinical and hematological manifestation of the disease and early reconvalescence phase. For analyzing the subpopulation composition of peripheral blood lymphocytes in children with IM the CD-receptors on cell surfaces (CD8, CD16) were defined; for estimating apoptosis the amount of CD95-, CD95L- and annexin V-positive lymph cells (immunofluorescence method) was assessed. For determination of TNFα concentration in cultural supernatants the solid-phase immunoenzyme method was applied. It was defined that clinical and hematological manifestation of IM is accompanied by increase in the amount of CD8-, CD16-lymphocytes in blood and activation of Fas-dependent apoptosis of lymphocytes that is preserved in early reconvalescence period. Here limitation of lymphocytic cytotoxicity results from a decrease in TNFα secretion.
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Dommerby, H., S. E. Stangerup, M. Stangerup, and S. Hancke. "Hepatosplenomegaly in infectious mononucleosis, assessed by ultrasonic scanning." Journal of Laryngology & Otology 100, no. 5 (May 1986): 573–80. http://dx.doi.org/10.1017/s0022215100099680.
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SummaryThe present study aims at an assessment of hepato-splenomegaly in infectious mononucleosis (IM). In 29 patients admitted to the ENT department with IM, based on the typical clinical and laboratory findings, including a positive mononucleosis test in most cases, the size of the liver and spleen was estimated by ultrasonic scanning on days 1, 3, 5, 10, 20, 30, 90 and 120 after admission. A control group of eight patients with peritonsillar abscess was included for comparison. The results showed that all patients had an enlarged spleen (mean enlargement: 50–60 per cent) but only a few were palpable. Half of the patients had enlargement of the liver (5–20 per cent), which was palpable in only 8 per cent. There was no correlation between the size of the spleen and that of the liver, not between the changes in the size of these organs. There was no enlargement of the liver or spleen in the control group. No correlation was found between the size, or changes in the size, of the organs and blood values such as lactatdehydrogenase and aspartatamino-transferase. There is, however, a striking parallelism between the curves for these parameters, which might indicate that the organs as well as the blood tests return to normal within 28 days. If this holds true, our warning to abstain from physical exercise and alcoholic intake may be limited to a period of about 1 month.
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Postanogova, Nina Olegovna, Lyudmila Vasil’evna Sofronova, and Ferdausa Ravkhatovna Milyakova. "Clinical and laboratory features of infectious mononucleosis depending on the etiological factor in children." Pediatrician (St. Petersburg) 6, no. 4 (December 15, 2015): 19–22. http://dx.doi.org/10.17816/ped6419-22.
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The article contains the results of observations in 54 children aged 1 to 6 years with infectious mononucleosis. The evaluated of clinical and laboratory data with consideration of the etiological factor of the disease. Depending on the etiology there are 3 groups of patients: 18 with EBV-associated IM, 18 with CMV IM and 18 with mixed etiology mononucleosis (EBV + CMV). All children received antibiotic therapy (cephalosporin of third generation), immunostimulatory drugs, in a dosage of age (recombinant interferon Alfa-2b) and symptomatic treatment. Verification of pathogens was carried out by enzyme-linked immunosorbent assay, were determined separately specific immunoglobulins M and G antibodies to EBV antigens and CMV. Disease in all children was accompanied by fever, tonsillitis, lymphadenopathy, enlarged liver and spleen. A laboratory study of characteristics was carried out at the time of admission and on day 11 of hospitalization. Intoxication with EBV IM were significantly more common than with CMV IM (p = 0,018). The pasty face was noted when mixed IM significantly more frequently than when monoethylamine versions (in comparison with EBV-IM p = 0,03, with CMV IM - p = 0,001). Splenomegaly in EBV + CMV IM more often met in comparison with EBV-IM (p = 0,01) and CMV- IM (p = 0,02). More significant levels of neutropenia and limfomonotsitozis occurred during the EBV-IM. Leukocytosis and increased ESR were more pronounced with CMV IM. Indicators of aminotransferases increased more significantly if EBV IM + CMV IM (in comparison with EBV IM p = 0,04, with CMV IM p = 0,05). On 11th day of hospitalization when the EBV IM in comparison with CMV IM remained more pronounced neutropenia and monocytosis (p = 0,04 and p = 0,05 respectively), nonspecific changes in laboratory indicators (leucocytosis, increased erythrocyte sedimentation rate) - CMV IM (p = 0,05 and p = 0,04 respectively).
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Azzi, Tarik, Anna Lünemann, Anita Murer, Seigo Ueda, Vivien Béziat, Karl-Johan Malmberg, Georg Staubli, et al. "Role for early-differentiated natural killer cells in infectious mononucleosis." Blood 124, no. 16 (October 16, 2014): 2533–43. http://dx.doi.org/10.1182/blood-2014-01-553024.
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Martynova, G. P., L. A. Ikkes, and Ya A. Bogvilenе. "Clinical features of infectious mononucleosis in children, depending on the etiological factor." Pacific Medical Journal, no. 4 (December 28, 2019): 70–73. http://dx.doi.org/10.34215/1609-1175-2019-4-70-73.
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Objective: The objective is to analyze clinical and laboratory features of infectious mononucleosis (IM) depending on disease etiology.Methods: 102 children with IM aged from 1 to 15 y.o. were examined. Polymerase chain reaction and immunoenzyme method were used to verify disease etiology.Results: In patients with Epstein–Barr virus and mixed infection, the most pronounced manifestations of lymphoproliferative syndrome and tonsillitis, high content of atypical mononuclear cells in peripheral blood are detected. Aspects of IM of cytomegaloviral etiology were notable for the prevalence of toxic syndrome along with other less pronounced clinical and laboratory manifestations of the disease.Conclusions: The detected features of the aspects of IM depending on etiological factor allow to prognosticate a variant and a character of the disease course and to early improve the therapy.
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Cai, Jie, Liping Yuan, Hui Gao, Bo Hu, and Ming Gui. "Clinical Characteristics and Empirical Research Model of Infectious Mononucleosis Complicated with Mycoplasma pneumoniae or/and Cytomegalovirus Infection." Computational and Mathematical Methods in Medicine 2021 (November 12, 2021): 1–5. http://dx.doi.org/10.1155/2021/2867913.
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To study the clinical features of infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV) mixed with Mycoplasma pneumonia (MP) or/and cytomegalovirus (CMV)infection, collected 201 hospitalized children who met the IM diagnostic criteria, the clinical manifestations, laboratory tests, complications, treatment, and outcome were compared among EBV infection alone and EBV mixed with MP or/and CMV infection. Most of the children with IM were preschoolers, more frequently occurred in boys than girls. EBV patients with MP had the longest duration of fever. When mixed pathogen infections were involved, the white blood cell count of preschool children was significantly increased, while splenomegaly was more common in older children. In the cases of EBV infection alone, abnormal liver function was positively correlated with age ( P = 0.044 ). Mixed pathogen infections were more common in children with IM, occurring in all age groups, and some clinical characteristics were related to the age of onset and the pathogen of the infection.
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Hussaini, Syed H., Nicola Pilkington, and John N. Barnes. "Infectious Mononucleosis Hepatitis – An Unwelcome Present for Father Christmas." Acute Medicine Journal 12, no. 2 (April 1, 2013): 98–101. http://dx.doi.org/10.52964/amja.0296.
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We describe a case of infectious mononucleosis (IM) hepatitis occurring in an elderly thespian, who had recently played the role of ‘Father Christmas’. We discuss the importance of differing clinical manifestations in older and younger age groups, the changing epidemiology of Epstein Barr (EB) infection within the United Kingdom and the role of different virology tests in establishing a diagnosis. Raised awareness of this changing pattern of disease could prevent unnecessary investigation and consequent potential iatrogenic complications.
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Solomay, T. V., and T. A. Semenenko. "Viral hepatitis B, C and infectious mononucleosis: epidemiological similarities and differences." Problems of Virology, Russian journal 65, no. 1 (March 17, 2020): 27–34. http://dx.doi.org/10.36233/0507-4088-2020-65-1-27-34.
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Introduction. The presence of etiologically unencrypted diagnoses in the structure of viral hepatitis determines the relevance of searching for other pathogens involved in liver pathology formation. The role of Epstein-Barr virus in the development of hepatitis was described in the scientific literature, but official statistics do not allow to assess its contribution to liver damage along with hepatitis B and C viruses.The purpose – to identify common and distinctive epidemiological features of viral hepatitis B (HB), C (HC) and infectious mononucleosis (IM).Material and methods. A retrospective epidemiological analysis of these nosologies incidence was carried out according to official statistics in 2009-2018 in the Russian Federation.Results and discussion. The multidirectional trends in the long-term dynamics of the incidence of IM, acute and chronic HB and HC and the presence of strong direct correlation between the acute and chronic HB and HC incidence were established. Distinctive features include disparity in epidemic process intensity in different age groups (prevalence of morbidity in children aged 1–2 and 3–6 years with IM and persons older than 18 years – with viral hepatitis). It is common for IM and HB and HC to involve the majority of urban population in the epidemic process, as well as children under the age of 1 year. The described differences are due to the action of transmission mechanisms specific to each infection.Conclusion. The results obtained in this study may serve as a basis for further study of the interaction of EpsteinBarr virus with hepatitis B and C viruses.
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Ikkes, L. A., A. A. Savchenko, G. P. Martinova, and I. I. Gvozdev. "Granulocyte-macrophage colony-stimulating factor: prospects for use in children with infectious mononucleosis." Voprosy praktičeskoj pediatrii 17, no. 5 (2022): 43–51. http://dx.doi.org/10.20953/1817-7646-2022-5-43-51.
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Objective. To analyze the production of active oxygen species (AOS) by peripheral blood neutrophils in children with infectious mononucleosis (IM) after their exposure to granulocyte-macrophage colony-stimulating factor (GM-CSF) in vitro. Patients and methods. We examined 78 children aged 3 to 11 years in the acute period of IM (including 47 children aged 3–6 years and 31 children aged 7–11 years). The control group comprised 40 healthy children matched for age. Luminoldependent chemiluminescence (CL) of peripheral blood neutrophils was assessed using the method of De Sole et al. The following CL parameters were measured: time to reach the maximum (Tmax), maximum value (Imax), and the area (S) under the chemiluminescent curve. Results. Children with IM (from both age groups) demonstrated lower spontaneous lucigenin-dependent chemiluminescence of neutrophils than controls: Tmax (p < 0.001 and p = 0.036, respectively), Imax (p = 0.024 and p = 0.025), and S (p = 0.01). Incubation of neutrophils with GM-CSF caused changes in luminol-dependent chemiluminescence only in children with MI from both age groups: Tmax decreased, whereas Imax and S increased. IM patients aged 7–11 years were found to have higher levels of chemiluminescence of neutrophils exposed to GM-CSF in vitro than IM patients aged 3–6 years (Tmax (p < 0.001) and SGM-CSF/Ssp. (p = 0.024)). Conclusion. Our findings suggest that GM-CSF can increase functional activity of neutrophils. This might facilitate adaptive immunity at periphery. Key words: infectious mononucleosis, neutrophilic granulocytes, chemiluminescence of neutrophils, granulocyte-macrophage colony stimulating factor
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Rostgaard, Klaus, Lone Graff Stensballe, Signe Holst Søegaard, Mads Kamper-Jørgensen, and Henrik Hjalgrim. "Childcare attendance and risk of infectious mononucleosis: A population-based Danish cohort study." PLOS ONE 16, no. 12 (December 22, 2021): e0261665. http://dx.doi.org/10.1371/journal.pone.0261665.
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Background The risk of infectious mononucleosis (IM) is affected both by crowding and by sibship structure, i.e., number and signed age differential between an index child and a sibling. Siblings provide protection against IM by pre-empting delayed primary Epstein-Barr virus infection with its associated high risk of IM. The association between childcare attendance and risk of IM, on the other hand, has never been studied in a large, well-characterized cohort. Methods Danish children born in July 1992 through 2016 with a completely known simple childcare attendance history before age 1.5 years (n = 908,866) were followed up for a hospital contact with an IM diagnosis at ages 1.5–26 years. Hazard ratios (HRs) of IM for an additional year of exposure were obtained from stratified Cox regression analyses, stratified by sex and year of birth, with age as the underlying time scale, adjusted for sibship structure, and sociodemographic variables including parental ethnicity and maternal age. Results An additional year of exclusively attending a daycare home (max 5 children) yielded HR = 0.90 (95% confidence interval 0.81–1.00), and similarly, each year of exclusively attending a childcare institution (e.g., crèche) yielded HR = 0.94 (0.84–1.06). Conclusions Forwarding enrollment in childcare by a year lowers the risk of IM later in life much less than having an additional sibling of comparable age and has no practical public health implications. We find our results suggestive of a random threshold for successful Epstein-Barr virus infection that is more easily reached by a sibling than the collective of playmates in daycare homes or childcare institutions.
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Tomkinson, B. E., R. Maziarz, and J. L. Sullivan. "Characterization of the T cell-mediated cellular cytotoxicity during acute infectious mononucleosis." Journal of Immunology 143, no. 2 (July 15, 1989): 660–70. http://dx.doi.org/10.4049/jimmunol.143.2.660.
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Abstract Primary infection with EBV during acute infectious mononucleosis (IM) is associated with a cytotoxic response against allogeneic target cells. C depletion with anti-CD3 (OKT3) and anti-CD8 (OKT8) mAb decreased the allogeneic cytolysis of two EBV-infected lymphoblastoid cell lines (LCL) by 96% and 89%, respectively. Complement depletion with the NK cell-specific mAb Leu-11b and NKH-1a resulted in only a slight decrease (less than 35%) in the lysis of these LCL. mAb inhibition studies with OKT3 and OKT8 inhibited the allogeneic lysis of two LCL by 87% and 82%, respectively. The alloreactive cytotoxic response was strongly inhibited by mAb specific for MHC class I determinants (W6/32, 65% inhibition and BBM.1, 58% inhibition). Acute IM lymphocytes lysed the allogeneic EBV-negative cell lines HSB2 (45%) and HTLV-1 T cell lines (16%). NK cell-depleted lymphocytes from an acute IM patient demonstrated preferential lysis of K562 transfected with human HLA-A2 (73%) compared with the K562 transfected control (20%). Cold target competition studies with allogeneic and autologous target and competitor LCL demonstrated no significant competitive inhibition between allogeneic and autologous cells. We interpret these results as evidence that 1) the acute IM-alloreactive cytotoxic response is mediated primarily by CTL; 2) these alloreactive CTL lyse allogeneic target cells irrespective of EBV antigenic expression; 3) MHC class I expression is sufficient for allogeneic recognition and lysis of target cells; 4) distinct effector CTL populations mediate lysis of autologous and allogeneic target cells; and 5) during acute IM, EBV infection results in the induction of both virus-specific and alloreactive CTL populations.
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Filatova, E. N., L. A. Solntsev, N. B. Presnyakova, E. A. Kulova, and O. V. Utkin. "DETERMINATION OF SOME IMMUNOLOGICAL FEATURES OF HHV-6-MEDIATED INFECTIOUS MONONUCLEOSIS IN CHILDREN BY THE METHOD OF DISCRIMINATORY ANALYSIS." Russian Journal of Infection and Immunity 8, no. 2 (September 10, 2018): 223–29. http://dx.doi.org/10.15789/2220-7619-2018-2-223-229.
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Human herpesvirus type 6 (HHV-6) is a lymphotropic virus that is an etiological agent of infectious mononucleosis (IM) in children. HHV-6- mediated infectious mononucleosis (HHV-6M) does not have clearly defined clinical features. Nowadays immunopathogenetic aspects of this disease have not been fully understood. The purpose of this work was to study the characteristics of the quantitative composition of populations of immunocompetent cells of peripheral blood in children with HHV-6M. The material for the study was samples of peripheral blood from children with “infectious mononucleosis” diagnosis and from virtually healthy children. Depending on the etiologic cause of the disease, children with IM were divided into three groups: HHV-6M, IM of other etiology and mixed infection (combination of HHV-6 and Epstein–Barr virus and/or Cytomegalovirus). Virtually healthy children formed the fourth group. In blood samples, the absolute content of the following populations of immunocompetent cells was determined by the method of flow cytometry: the total population of T-lymphocytes, T- helpers, cytotoxic T-lymphocytes, double positive T-lymphocytes (CD4+CD8+), NK cells and B-lymphocytes. Discriminant analysis was carried out: based on the obtained data on the population composition of blood cells we constructed a model of a child’s attribution to one of the four groups analyzed in pairs. We used the method of machine learning — the algorithm of gradient boosting over decision trees. It was determined whether it is possible to classify patients on the basis of the studied indicators and which combination of indicators is optimal for classification. As a result of the study it was possible to classify the following pairs of groups: healthy children — children with HHV- 6M, healthy children — children with IM of other etiology, children with HHV-6M — children with IM of other etiology. When solving the problem of classifying children from group with mixed infection and from any other group, it was not possible to find a model of satisfactory quality. In comparison with virtually healthy children, children with HHV-6M were characterized by an increased content of the total population of T-lymphocytes and cytotoxic T-cells, as well as by a reduced content of doub le-positive T-lymphocytes. Compared with children with IM of other etiology, children with HHV-6M were characterized by an increased content of cytotoxic T-lymphocytes, T- helpers, B-lymphocytes and a reduced number of double-positive T cells. Our results indicate that HHV-6-mediated infectious mononucleosis causes changes in the quantitative composition of certain populations of immunocompetent cells of peripheral blood, different from those of other etiology, in children.
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Nishioka, Hiroaki, Katsuma Hayashi, and Hayato Shimizu. "Case Report: Splenic Infarction in Infectious Mononucleosis due to Epstein–Barr Virus Infection." American Journal of Tropical Medicine and Hygiene 106, no. 2 (February 2, 2022): 623–25. http://dx.doi.org/10.4269/ajtmh.21-0943.
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ABSTRACT. Epstein–Barr virus (EBV) is the most common cause of infectious mononucleosis (IM) and IM is a clinical syndrome typically characterized by fever, pharyngitis, and cervical lymph node enlargement. We describe the case of a 19-year-old man with IM complicated by splenic infarction. The patient visited our hospital because of upper abdominal pain without a fever and sore throat. Abdominal computed tomography revealed a low-density area in the spleen, which indicated splenic infarction. The next day, he developed a fever. After diminishing abdominal pain and fever, he developed pharyngitis accompanied by fever. Acute EBV infection was confirmed by serological tests. The patient was successfully managed with no specific therapy. Splenic infarction is a rare complication of IM and this case showed that splenic infarction can precede a fever and pharyngitis.
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Ryan, Caroline, Chirajit Dutta, and Ricard Simo. "Role of screening for infectious mononucleosis in patients admitted with isolated, unilateral peritonsillar abscess." Journal of Laryngology & Otology 118, no. 5 (May 2004): 362–65. http://dx.doi.org/10.1258/002221504323086552.
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Two hundred and four cases of in-patient admission with isolated, unilateral peritonsillar abscess over the three-year period 1999–2001 were reviewed retrospectively. One hundred and fifty-one patients had been screened for infectious mononucleosis (IM) using the heterophile antibody screening test. Of these 142 (94 per cent) tested negative and nine (six per cent) positive. There were no IM-typical clinical or haematological signs in any of the IM positive patients to facilitate the prediction of the diagnosis. Due to the comparatively high prevalence of positives, the low cost of screening, the lack of predictive signs and the diversity of potential complications of IM, routine screening in all patients presenting with peritonsillar abscess is recommended.
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Hasibi, Mehrdad, Mahsa Zargaran, and Ali Asadollahi-Amin. "Infectious Mononucleosis Complicated with Bilateral Peritonsillar Abscess and Splenic Infarction." Case Reports in Infectious Diseases 2021 (March 12, 2021): 1–4. http://dx.doi.org/10.1155/2021/6623834.
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Infectious mononucleosis (IM) due to Epstein–Barr virus (EBV) infection is usually self-limited. It presents with fever, pharyngitis, fatigue, and cervical lymph node enlargement. It is common among adolescents and young adults. Although most patients recovered without any sequelae, rare complications have been reported. We described a 28-year-old man with fever, sore throat, dysphagia, and a positive IgM viral capsid Ag (VCA Ag) for EBV infection. He was admitted and received dexamethasone. He developed bilateral peritonsillar abscess (PTA) and splenic infarction, rare complications of acute EBV infection, two days after discharge. Although early reports noted PTA might occur following dexamethasone administration, recently, no obvious evidence supports it. However, high erythrocyte sedimentation rate level in our patient might indicate bacterial superinfection, which could exacerbate with dexamethasone administration. Several mechanisms such as transient hypercoagulable state and insufficient blood supply due to splenomegaly were proposed for splenic infarction due to EBV infection. Since our patient remained asymptomatic during the disease, IM-associated splenic complications, including splenic infarction, should be kept in mind. Our patient underwent bilateral tonsillectomy and received conservative management for the splenic infarction. These two rare complications of acute EBV infection have not been reported simultaneously yet.
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Aslan, Nuray, Levi Watkin, Katherine Luzuriaga, and Liisa Selin. "Crossreactive influenza A virus M1- and EBV-BMLF-1-specific CD8 T cells modulate disease severity of Epstein-Barr Virus-induced infectious mononucleosis (49.20)." Journal of Immunology 186, no. 1_Supplement (April 1, 2011): 49.20. http://dx.doi.org/10.4049/jimmunol.186.supp.49.20.
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Abstract During EBV-associated infectious mononucleosis (IM) influenza A-specific crossreactive memory T cells are highly activated and play a role in disease severity. In HLA-A2+ IM patients, influenza M158 (IAV-M1)-specific CD8 memory T cell responses cross-reacted with two different EBV lytic epitopes, BRLF-1(190) (19/20) and BMLF-1(280) (17/29). Furthermore, 11/22 IM patients demonstrated some intra-viral cross-reactivity between EBV-BRLF-1 and -BMLF-1 responses. Disease severity of IM did not correlate with viral load, but instead directly correlated with the percentage of IAV-M1, EBV-BMLF-1 and crossreactive IAV-M1/EBV-BMLF-1-specific CD8 T cells. This was associated with altered TCR Vbeta usage. In all IM patients cross-reactive T cell responses were observed but different patterns of cross-reactivity were seen in each individual. A number of unique features of the TCR of the highly cross-reactive BRLF-1 epitope were noted. BRLF-1 T cell responses were of very high avidity. There was tremendous variation in the Vbeta usage between different individuals and even in the same individual over time. Cross-reactive BRLF-1 responses only became apparent at higher antigen doses in vitro, such as might occur during different phases of infectious mononucleosis.
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GROTTO, I., D. MIMOUNI, M. HUERTA, M. MIMOUNI, D. COHEN, G. ROBIN, S. PITLIK, and M. S. GREEN. "Clinical and laboratory presentation of EBV positive infectious mononucleosis in young adults." Epidemiology and Infection 131, no. 1 (August 2003): 683–89. http://dx.doi.org/10.1017/s0950268803008550.
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Clinical descriptions of Epstein–Barr virus (EBV) positive infectious mononucleosis (IM) are rare and their results are inconsistent. Over a 4-year period, we prospectively studied 590 young adults with clinically suspected IM, all of whom were tested for the presence of EBV IgM antibodies. We investigated the demographical, clinical and laboratory features of subjects with positive EBV IgM serology and heterophile antibodies. Contrary to previous studies, we found a seasonal disease pattern with a peak incidence during summer months, and a lower-than-expected prevalence of lymphadenopathy (88·9%), leucocytosis (46·2%), atypical lymphocytosis (89·2%) and elevated liver enzymes (57·9%). The prevalence of hyperbilirubinemia was relatively high (14·9%). The classic triad of fever, sore throat and lymph-adenopathy had relatively low sensitivity (68·2%) and specificity (41·9%) for EBV infection. Our study provides a complete and updated description of the clinical and laboratory presentation of laboratory confirmed IM, which is important for both clinicians and epidemiologists.
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Ythier, Arnaud, Jean-Franclois Moreau, Marie-Alix Peyrat, Jean-Denis Bignon, and Jean-Paul Soulillou. "HLA-AB and -DR types in patients with infectious mononucleosis (IM)." Tissue Antigens 21, no. 4 (December 11, 2008): 329–32. http://dx.doi.org/10.1111/j.1399-0039.1983.tb00179.x.
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Kanderi, Tejaswi, and Maged S. Khoory. "Infectious mononucleosis mimicking Epstein–Barr virus positive diffuse large B-cell lymphoma not otherwise specified." International Journal of Hematologic Oncology 9, no. 2 (June 1, 2020): IJH25. http://dx.doi.org/10.2217/ijh-2020-0002.
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The Epstein–Barr virus (EBV) causes infectious mononucleosis (IM). In the case of atypical presentation, lymph node and tonsillar biopsies are required to rule out lymphoma. Here, we discuss an 83-year-old male who presented with findings suggestive of diffuse large B-cell lymphoma, which was later ruled out in favor of IM. The distinction between IM and lymphomas is quite challenging due to the extensive overlap between the two diseases. Various studies have demonstrated that EBV-positive diffuse large B-cell lymphoma mimics IM due to large B-cell proliferation in acute EBV infection. We suggest testing for acute EBV infection in addition to utilizing advanced testing to confirm IM in patients with atypical infection, to avoid misdiagnosis leading to inappropriate treatment.
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Janani, Madhuravasal Krishnan, Jambulingam Malathi, Andal Appaswamy, Nishi Rani Singha, and Hajib Nariharirao Madhavan. "A hospital based pilot study on Epstein-Barr virus in suspected infectious mononucleosis pediatric patients in India." Journal of Infection in Developing Countries 9, no. 10 (October 29, 2015): 1133–38. http://dx.doi.org/10.3855/jidc.6199.
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Introduction: Infectious mononucleosis (IM) caused by the Epstein-Barr virus (EBV) is commonly diagnosed by detection of antibodies in the patient’s sera. Differentiation of acute from chronic and differential diagnosis of EBV-induced IM from IM-like syndrome caused by human cytomegalovirus (CMV) is important. The objective of this study was to standardize and use polymerase chain reaction (PCR) for diagnosis of EBV and evaluate it against enzyme-linked immunosorbent assay (ELISA). Methodology: ELISA for detection of IgM and IgG antibodies to viral capsid antigen (VCA) and PCR targeting the VCA and EBNA1 gene of EBV and mtrII gene of CMV were performed on180 peripheral blood samples collected from 180 patients with suspected IM. The analytical sensitivity of PCR was evaluated against that of ELISA. Results: Using the standard serological profile as the reference, the EBV-VCA gene was detected in 41 (95%) of 45 samples collected from patients with early primary infections, in 41 (54%) of 75 with recent primary infections, and in7 (17%) of 39 with past infections. The result of VCA PCR was statistically significant in virus detection during early or primary stage of infection. Nineteen (49%) EBV-seropositive samples were positive for CMV by PCR. All control samples tested negative for both VCA and EBNA1by PCR. Conclusions: VCA PCR is sensitive for the detection of EBV DNA in the early or primary stage of infection and can be considered a reliable method to rule out the cross-reactivity and differential diagnosis of EBV-induced IM from IM-like syndrome.
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Gómez, M. Concepción, Jose A. Nieto, and M. Angeles Escribano. "Evaluation of Two Slide Agglutination Tests and a Novel Immunochromatographic Assay for Rapid Diagnosis of Infectious Mononucleosis." Clinical Diagnostic Laboratory Immunology 7, no. 5 (September 1, 2000): 840–41. http://dx.doi.org/10.1128/cdli.7.5.840-841.2000.
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ABSTRACT The results of three tests used for the rapid diagnosis of infectious mononucleosis (IM) were compared with those of Epstein-Barr virus-specific serology. The sensitivities ranged from 15 to 33% in children under 13 years of age and from 59 to 81% in patients over 13 years. The specificities ranged from 86 to 100% in both age groups. These tests have a poor sensitivity for the diagnosis of IM, particularly in children.
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Filatova, E. N., N. A. Sakharnov, O. V. Utkin, and E. A. Kulova. "Determining molecular and genetic markers for severe EBV-mononucleosis." Russian Journal of Infection and Immunity 10, no. 4 (November 27, 2020): 707–16. http://dx.doi.org/10.15789/2220-7619-dma-1271.
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Epstein—Barr virus (EBV) is one of the etiological agents causing infectious mononucleosis. A severe form of the disease can result in developing serious complications, which risk might also depend on the state of patient’s immune system. To date, no specific tests for assessing a risk of developing severe disease form are available. Our study was aimed at identifying molecular genetic markers of severe EBV-infectious mononucleosis (EBV-IM) in immunocompetent peripheral blood cells. Expression of 483 genes and gene transcripts regulating apoptosis, proliferation and differentiation of immunocompetent cells was measured in the peripheral blood leukocytes from patients with severe and moderate EBV-IM as well as apparently healthy donors. A DNA-microarray designed by us and subsequent data processing were carried out by using custom-made “MiDA” software. To identify markers of a severe form of the pathology, expression of each gene and transcript was compared in EBV-IM patients and apparently healthy donors. For each gene and transcript, the level of expression fold change and significance for binary classification were determined. Genes and transcripts, characterized by the maximum values of two determined parameters while comparing patients with severe infection and healthy donors, as well as patients with severe and moderate EBV-IM forms, were selected as markers of severe EBV-IM. Genes and transcripts with differed expression in patients with moderate EBV-IM and healthy donors, were excluded from the list of markers. In addition, sex- and age-linked markers with differed expression were excluded as well. The markers for severe EBV-IM consisted of apoptosis regulators (BCL2L11, BIRC3 genes and XIAP.NM_001167 transcript) and splicing factors (CELF6 gene and SF1.NM_201995 transcript). Compared with donors and patients with a moderate form of the disease, a decreased expression of BCL2L11, BIRC3 genes, transcripts SF1.NM_201995 and XIAP.NM_001167, as well as increased expression of the CELF6 gene were detected in the blood of patients with severe EBV-IM. The functional role of identified molecular markers suggests that severe EBV-IM is characterized by suppressed mitochondrial and activated TRAF-dependent apoptosis pathways in immunocompetent cells. The expression pattern for select markers is specific for severe EBV-MI, not associated with patient sex and age. Thus, study data may be used to develop specific tools for assessing a risk of developing complications of EBV mononucleosis.
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Levine, Dorothy, Rosemary Klenk, Alan Morelli, Nancy Hofreuter, Richard C. Tilton, and Michael F. Parry. "False Positive EBNA IgM and IgG Antibody Tests for Infectious Mononucleosis in Children." Pediatrics 94, no. 6 (December 1, 1994): 892–94. http://dx.doi.org/10.1542/peds.94.6.892.
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Objectives. To assess the reliability of the Monolert test, a new enzyme-linked immunosorbent assay for the diagnosis of acute infectious mononucleosis (IM). Design. A retrospective laboratory and clinical analysis of 38 children diagnosed with acute IM. Setting. A suburban pediatric practice in Connecticut. Patients. Thirty-eight children (ages 18 months to 17 years) who were diagnosed with acute IM using the Monolert test during the period October 1992 to August 1993. Results. Eighty-three percent of these children had no evidence of Epstein-Barr virus infection on subsequent investigation. The false positive results of the Monolert test could not be explained on the basis of elevated antibody titers to either cytomegalovirus or Borrelia burgdorferi. Conclusion. Monolert is a poor screening test and is of little apparent value as a diagnostic test for acute Epstein-Barr virus infection in pediatric patients.
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Endriz, John, Peggy P. Ho, and Lawrence Steinman. "Time correlation between mononucleosis and initial symptoms of MS." Neurology - Neuroimmunology Neuroinflammation 4, no. 3 (February 27, 2017): e308. http://dx.doi.org/10.1212/nxi.0000000000000308.
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Objective:To determine the average age of MS onset vs the age at which Epstein-Barr infection has previously occurred and stratify this analysis by sex and the blood level of Epstein-Barr nuclear antigen 1 (EBNA1) antibody.Methods:Using infectious mononucleosis (IM) as a temporal marker in data from the Swedish epidemiologic investigation of MS, 259 adult IM/MS cases were identified and then augmented to account for “missing” childhood data so that the average age of MS onset could be determined for cases binned by age of IM (as stratified by sex and EBNA1 titer level).Results:Mean age of IM vs mean age of MS reveals a positive time correlation for all IM ages (from ∼5 to ∼30 years), with IM-to-MS delay decreasing with increased age. When bifurcated by sex or EBNA1 blood titer levels, males and high-titer subpopulations show even stronger positive time correlation, while females and low-titer populations show negative time correlation in early childhood (long IM/MS delay). The correlation becomes positive in females beyond puberty.Conclusions:IM/MS time correlation implies causality if IM is time random. Alternative confounding models seem implausible, in light of constraints imposed by time-invariant delay observed here. Childhood infection with Epstein-Barr virus (EBV) in females and/or those genetically prone to low EBNA1 blood titers will develop MS slowly. Males and/or high EBNA1-prone develop MS more rapidly following IM infection at all ages. For all, postpubescent EBV infection is critical for the initiation and rapid development of MS.
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Lossius, Andreas, Trond Riise, Maura Pugliatti, Kjetil Bjørnevik, Ilaria Casetta, Jelena Drulovic, Enrico Granieri, et al. "Season of infectious mononucleosis and risk of multiple sclerosis at different latitudes; the EnvIMS Study." Multiple Sclerosis Journal 20, no. 6 (September 26, 2013): 669–74. http://dx.doi.org/10.1177/1352458513505693.
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Background: Seasonal fluctuations in solar radiation and vitamin D levels could modulate the immune response against Epstein-Barr virus (EBV) infection and influence the subsequent risk of multiple sclerosis (MS). Methods: Altogether 1660 MS patients and 3050 controls from Norway and Italy participating in the multinational case-control study of Environmental Factors In Multiple Sclerosis (EnvIMS) reported season of past infectious mononucleosis (IM). Results: IM was generally reported more frequently in Norway ( p=0.002), but was associated with MS to a similar degree in Norway (odds ratio (OR) 2.12, 95% confidence interval (CI) 1.64–2.73) and Italy (OR 1.72, 95% CI 1.17–2.52). For all participants, there was a higher reported frequency of IM during spring compared to fall ( p<0.0005). Stratified by season of IM, the ORs for MS were 1.58 in spring (95% CI 1.08–2.31), 2.26 in summer (95% CI 1.46–3.51), 2.86 in fall (95% CI 1.69–4.85) and 2.30 in winter (95% CI 1.45–3.66). Conclusions: IM is associated with MS independently of season, and the association is not stronger for IM during spring, when vitamin D levels reach nadir. The distribution of IM may point towards a correlation with solar radiation or other factors with a similar latitudinal and seasonal variation.
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Brichkov, I., L. Cummings, R. Fazylov, and J. H. Horovitz. "Nonoperative Management of Spontaneous Splenic Rupture in Infectious Mononucleosis: The Role for Emerging Diagnostic and Treatment Modalities." American Surgeon 72, no. 5 (May 2006): 401–4. http://dx.doi.org/10.1177/000313480607200507.
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Infectious mononucleosis (IM) is a self-limiting lymphoproliferative disorder affecting teenagers and young adults. Splenomegaly is a common manifestation of IM and results in a compromised organ that may rarely rupture spontaneously, with significant morbidity and mortality. The IM spleen should be protected from even minor trauma. Although traditional management of spontaneous splenic rupture in IM has been splenectomy, the role of nonoperative management is evolving. The advent of endovascular interventional modalities has augmented the physician's armamentarium in managing these patients nonoperatively. We report a case of spontaneous splenic rupture in a patient with IM managed conservatively with the aid of splenic angiography. The option of arteriography, with or without embolization, should be considered in the management of all patients with spontaneous splenic rupture in the setting of IM.
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Bravo, Dayana, Beatriz Muñoz-Cobo, Elisa Costa, M. Angeles Clari, Nuria Tormo, and David Navarro. "Evaluation of an Immunofiltration Assay That Detects Immunoglobulin M Antibodies against the ZEBRA Protein for the Diagnosis of Epstein-Barr Virus Infectious Mononucleosis in Immunocompetent Patients." Clinical and Vaccine Immunology 16, no. 6 (April 29, 2009): 885–88. http://dx.doi.org/10.1128/cvi.00123-09.
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ABSTRACT The performance of an immunofiltration assay (IMFA) that detects immunoglobulin M (IgM) antibodies to the Epstein-Barr virus (EBV) ZEBRA (BamHI Z EBV replication activator) protein was evaluated for the diagnosis of EBV infectious mononucleosis (IM) in immunocompetent patients. The test panel consisted of 47 sera displaying an EBV-specific antibody profile compatible with an acute primary EBV infection from patients with clinical and biological features of EBV IM, 20 sera from healthy individuals either with a past EBV infection or who were EBV seronegative, 20 sera displaying an equivocal EBV antibody pattern (viral capsid antigen IgG positive [VCA IgG+], VCA IgM+, and EBV nuclear antigen-1 IgG+), and 15 sera obtained from patients with a mononucleosis-like syndrome owing to cytomegalovirus, human herpesvirus 6, or parvovirus B19. Overall, the sensitivity and the specificity of the assay were found to be 92.5%, and 97.3%, respectively. The sensitivity of the assay for the diagnosis of heterophile antibody-negative EBV IM was 86.2%. The IMFA is rapid, easy to perform, and, thus, suitable for point-of-care testing, and it may be used as a first-line test for the diagnosis of acute EBV IM in immunocompetent patients.
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Guz O. V., Kuznetsov S., and Malutenko C. "IMMUNOPATHOGENETIC FEATURES OF MONONUCLEOSIS IN CHILDREN WITH VARIOUS MICROBIAL FLORA OF THE RHINOPHARYNX." World Science 2, no. 11(51) (November 30, 2019): 21–24. http://dx.doi.org/10.31435/rsglobal_ws/30112019/6771.
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One of the most common childhood diseases is infectious mononucleosis (IM), which Epstein-Barr virus (EBV) is a causative factor. According to WHO statistics, more than 5 million children die every year from the indicated infectious pathology and its consequences in the world. Streptococcus pyogenes, Streptococcus pneumoniae and other Streptococcus, Enterococcus, Lactobacillus Actinomices, Neisseria, Actinomyces, Clostridium, Pseudomonas, Staphylococus epidermidis, Staphylococus aureus are most often detected in the oral cavity and nasopharynx. In the available literature there are practically no works that would consider the effect of microbial flora of the mucous membrane of the rhinopharynx on the formation of the immune response of children with IM.
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Panikkar, Archana, Corey Smith, Andrew Hislop, Nick Tellam, Vijayendra Dasari, Kristin A. Hogquist, Michelle Wykes, et al. "Impaired Epstein-Barr Virus-Specific Neutralizing Antibody Response during Acute Infectious Mononucleosis Is Coincident with Global B-Cell Dysfunction." Journal of Virology 89, no. 17 (June 24, 2015): 9137–41. http://dx.doi.org/10.1128/jvi.01293-15.
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Here we present evidence for previously unappreciated B-cell immune dysregulation during acute Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM). Longitudinal analyses revealed that patients with acute IM have undetectable EBV-specific neutralizing antibodies and gp350-specific B-cell responses, which were associated with a significant reduction in memory B cells and no evidence of circulating antibody-secreting cells. These observations correlate with dysregulation of tumor necrosis factor family members BAFF and APRIL and increased expression of FAS on circulating B cells.