{"id":398,"date":"2023-09-16T22:09:46","date_gmt":"2023-09-16T21:09:46","guid":{"rendered":"https:\/\/microregistrar.com\/?p=398"},"modified":"2023-09-16T22:09:46","modified_gmt":"2023-09-16T21:09:46","slug":"infectious-mononucleosis-and-epstein-barr-virus","status":"publish","type":"post","link":"https:\/\/microregistrar.com\/?p=398","title":{"rendered":"Infectious mononucleosis and Epstein-Barr Virus"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\" id=\"cause\">Cause:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Commonest cause \u2013 EBV.<\/li>\n\n\n\n<li>Other causes of mononucleosis-like syndrome \u2013 CMV, HIV (during seroconversion), Toxoplasma, Hepatitis virus, Adenovirus etc<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"epidemiology\">Epidemiology:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Primary EBV infection and infectious mononucleosis are common in children, teenagers and young adults.<\/li>\n\n\n\n<li>95% of healthy individuals are infected with EBV.<\/li>\n\n\n\n<li>In children, infection is usually mild or even asymptomatic.<\/li>\n\n\n\n<li>Symptomatic disease is common in teenagers and young adults (15-24 years).<\/li>\n\n\n\n<li>In adults, the infection is less common but often severe.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"transmission\">Transmission:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>It is transmitted via body fluid. Saliva is the commonest mode.<\/li>\n\n\n\n<li>Once infected, an individual can shed the virus in the saliva for approx\u20146 months, and intermittently, lifelong.<\/li>\n\n\n\n<li>It is called kissing disease but can be transmitted via less intimate contact than this.<\/li>\n\n\n\n<li>Other modes are \u2013 sexual contact and breastfeeding.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"signs-and-symptoms\">Signs and symptoms:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Triad of \u2013 Fever, tonsillar pharyngitis and lymphadenopathy.<\/li>\n\n\n\n<li>Other common features are \u2013 fatigue, splenomegaly (up to 60% cases) and low mood.<\/li>\n\n\n\n<li>You may also find \u2013 hepatomegaly, rash, headache and body ache.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"complications\">Complications<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Usually self-limiting disease.<\/li>\n\n\n\n<li>Neurological complications \u2013 meningoencephalitis, transverse myelitis, optic neuritis, Cranial nerve palsy, Guillain\u2013Barr\u00e9 syndrome.<\/li>\n\n\n\n<li>Haematological complications \u2013 aplastic anaemia, thrombocytopenia and related complications.<\/li>\n\n\n\n<li>Other complications \u2013 Splenic rupture, airway obstruction, myocarditis, hepatitis, and renal failure.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"diagnosis\">Diagnosis<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Typical clinical features<\/li>\n\n\n\n<li>Haematology \u2013 increased white cell count, atypical lymphocytes, anaemia, thrombocytopenia.<\/li>\n\n\n\n<li>Heterophile antibody test \u2013 e.g. Paul Bunnel test or monospot test<\/li>\n\n\n\n<li>EBV serology<\/li>\n\n\n\n<li>EBV PCR<\/li>\n<\/ul>\n\n\n\n<p>If you want to know about a heterophile antibody, see this video.<\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<ul class=\"wp-block-list\">\n<li>Heterophile antibody test should not be done in children &lt;4 years or immunocompromised patients (risk of false-negative result)<\/li>\n\n\n\n<li>False-positive results can be seen in \u2013 rheumatoid disease, SLE, leukaemia, lymphoma, infections including malaria, HIV, CMV, rubella, viral hepatitis, tularaemia etc.<\/li>\n\n\n\n<li>90% of patients are expected to be positive heterophil antibodies by 3 weeks, and they disappear at approximately three months.<\/li>\n<\/ul>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-4-3 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Heterophile Antibodies\" width=\"500\" height=\"375\" src=\"https:\/\/www.youtube.com\/embed\/kUVkF5OicN0?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n<\/div>\n<\/div>\n\n\n\n<p><strong>Atypical lymphocytes<\/strong>&nbsp;can also be seen in CMV, HIV, HHV6, rubella, mumps, viral hepatitis, toxoplasmosis, typhus, lead poisoning etc.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"differential-diagnosis\">Differential diagnosis:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Streptococcal sore throat (Group A Streptococcus)<\/li>\n\n\n\n<li>Mononucleosis-like syndrome \u2013 CMV, HIV seroconversion, Toxoplasma infection, Viral hepatitis, Adenovirus etc.<\/li>\n\n\n\n<li>Leukaemia<\/li>\n\n\n\n<li>Drugs \u2013 phenytoin, carbamazepine<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"treatment\">Treatment:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Usually, self-limiting.<\/li>\n\n\n\n<li>Supporting treatment \u2013 nutrition, hydration<\/li>\n\n\n\n<li>Paracetamol, NSAIDs<\/li>\n\n\n\n<li>Steroids and acyclovir \u2013 selected cases<\/li>\n\n\n\n<li>Avoid sports for 4 weeks (risk of splenic rupture).<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Infectious mononucleosis and EBV\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/18QNehhUtNg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Cause: Epidemiology: Transmission: Signs and symptoms: Complications Diagnosis If you want to know about a heterophile antibody, see this video. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ngg_post_thumbnail":0,"footnotes":""},"categories":[107,19],"tags":[114,115],"class_list":["post-398","post","type-post","status-publish","format-standard","hentry","category-infection","category-virology","tag-ebv","tag-infectious-mononucleosis"],"_links":{"self":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/398","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=398"}],"version-history":[{"count":1,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/398\/revisions"}],"predecessor-version":[{"id":400,"href":"https:\/\/microregistrar.com\/index.php?rest_route=\/wp\/v2\/posts\/398\/revisions\/400"}],"wp:attachment":[{"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=398"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=398"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/microregistrar.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=398"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}