MedWorm: Glandular Fever (infectious mononucleosis)

Self‐reported history of infections and the risk of non‐Hodgkin lymphoma: An InterLymph pooled analysis

International Journal of Cancer — Mon, 23 Jan 2012 13:06:18 +0100

AbstractWe performed a pooled analysis of data on self‐reported history of infections in relation to the risk of non‐Hodgkin lymphoma (NHL) from 17 case‐control studies that included 12,585 cases and 15,416 controls aged 16‐96 years at recruitment. Pooled odds ratios (OR) and 95% confidence intervals (95% CI) were estimated in two‐stage random‐effect or joint fixed‐effect models, adjusting for age, sex and study centre. Data from the two years prior to diagnosis (or date of interview for controls) were excluded. A self‐reported history of infectious mononucleosis (IM) was associated with an excess risk of NHL (OR=1.26, 95% CI=1.01‐1.57 based on data from 16 studies); study‐specific results indicate significant (I2=51%, p=0.01) heterogeneity. A self‐reported history of...

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A review of the cytomorphology of epstein-barr virus-associated malignancies.

Herpes — Fri, 13 Jan 2012 11:30:16 +0100

Authors: Michelow P, Wright C, Pantanowitz L Abstract The Epstein-Barr virus (EBV) is a member of the herpes family of viruses and is very common in humans. EBV is most often associated with infectious mononucleosis. However, it is estimated that 1% of tumors including lymphoproliferative, epithelial and mesenchymal are linked to EBV infection. EBV has a tropism for certain epithelial cells, lymphocytes and myocytes. Like other herpesviruses, EBV has both lytic and latent phases of infection. In the latent form, EBV-encoded genes ensure the survival of the viral genome, allowing it to circumvent the host's immune surveillance by limited expression of viral proteins and carries with it the risk of neoplastic transformation. Cytologists are likely to encounter EBV-associated malignan...

Common virus may trigger MS nerve damage

New Scientist - Health — Tue, 10 Jan 2012 12:14:33 +0100

Epstein-Barr virus causes glandular fever, but could also damage brain cells, causing the symptoms of multiple sclerosis (Source: New Scientist - Health)

Risk Factors For Chronic Cerebrospinal Venous Insufficiency Are Similar To Risk Factors For Developing Multiple Sclerosis: UB Study

Health News from Medical News Today — Thu, 01 Dec 2011 10:00:00 +0100

Summary: A vascular condition called chronic cerebrospinal venous insufficiency (CCSVI), which has attracted global attention as possibly being correlated with MS has, for the first time, been studied for the presence of risk factors in subjects who do not have a neurological disease. A preliminary University at Buffalo study of 252 volunteers has found an association between CCSVI and as many as three characteristics widely viewed as possible or confirmed MS risk factors. They are: infectious mononucleosis, irritable bowel syndrome and smoking... (Source: Health News from Medical News Today)

An adult case of chronic active epstein-barr virus infection with interstitial pneumonitis.

The Korean Journal of Internal Medicine — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Joo EJ, Ha YE, Jung DS, Cheong HS, Wi YM, Song JH, Peck KR Abstract Chronic active Epstein-Barr virus (CAEBV) infection is characterized by persistent infectious mononucleosis-like symptoms, an unusual pattern of Epstein-Barr virus (EBV) antibodies, detection of the EBV genome in affected tissues or peripheral blood, and chronic illness that cannot be attributed to any other known disease. This is the first reported Korean case of an immunocompetent adult with CAEBV-associated interstitial pneumonitis. A 28-year-old female was admitted with a fever that persisted for 3 weeks. She had multiple lymphadenopathy, hepatosplenomegaly, pancytopenia, and elevated serum aminotransferase levels. Serology for antibodies was positive and chest computed tomography showed diffuse ground...

[Aman with persisting fever, night sweats and high sedimentation rate].

Tidsskrift for den Norske Laegeforening — Tue, 29 Nov 2011 05:00:00 +0100

[Aman with persisting fever, night sweats and high sedimentation rate]. Tidsskr Nor Laegeforen. 2011 Nov 29;131(23):2362-5 Authors: Kildahl-Andersen O, Murbræch K, Skudal H, Stalsberg H Abstract Background. Fever of unknown origin and high sedimentation rate are common clinical problems. Material and methods. A middle-aged man with fever of unknown origin, night sweats and high sedimentation rate was referred to our hospital for investigation. Results and interpretation.The patient was suspected to have mononucleosis or reactivation of infectious mononucleosis because of mild anaemia and thrombocytopenia, a weakly postive IgM antibody test for Epstein-Barr virus and monocytosis (in peripheral blood). Because monocytosis, elevated sedimentation rate and fever persisted, bon...

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Epstein-Barr virus: general factors, virus-related diseases and measurement of viral load after transplant

Revista Brasileira de Hematologia e Hemoterapia — Fri, 25 Nov 2011 10:35:13 +0100

The Epstein-Barr virus is responsible for infectious mononucleosis syndrome and is also closely associated to several types of cancer. The main complication involving Epstein-Barr virus infection, both in recipients of hematopoietic stem cells and solid organs, is post-transplant lymphoproliferative disease. The importance of this disease has increased interest in the development of laboratory tools to improve post-transplant monitoring and to detect the disease before clinical evolution. Viral load analysis for Epstein-Barr virus through real-time polymerase chain reaction is, at present, the best tool to measure viral load. However, there is not a consensus on which sample type is the best for the test and what is its predictive value for therapeutic interventions. (Source: Revista Brasi...

Acute or Chronic Life-Threatening Diseases Associated With Epstein-Barr Virus Infection.

The American Journal of the Medical Sciences — Thu, 17 Nov 2011 05:00:00 +0100

Authors: Okano M, Gross TG Abstract Infectious mononucleosis (IM) is one of the representative, usually benign, acute diseases associated with primary Epstein-Barr virus (EBV) infection. IM is generally self-limiting and is characterized mostly by transient fever, lymphadenopathy and hepatosplenomegaly. However, very rarely primary EBV infection results in severe or fatal conditions such as hemophagocytic lymphohistiocytosis together with fulminant hepatitis designated as severe or fatal IM or EBV-associated hemophagocytic lymphohistiocytosis alone. In addition, chronic EBV-associated diseases include Burkitt's lymphoma, undifferentiated nasopharyngeal carcinoma, Hodgkin lymphoma, T-cell lymphoproliferative disorder (LPD)/lymphoma, natural killer-cell LPD including leukemia or lymp...

Vaccine Could Prevent Mononucleosis And Cancers Linked To Epstein-Barr Virus

Health News from Medical News Today — Fri, 04 Nov 2011 09:00:00 +0100

Epstein-Barr virus (EBV) infects nine out of ten people worldwide at some point during their lifetimes. Infections in early childhood often cause no disease symptoms, but people infected during adolescence or young adulthood may develop infectious mononucleosis, a disease characterized by swollen lymph nodes, fever and severe fatigue. EBV also is associated with several kinds of cancer, including Hodgkin lymphoma and stomach and nasal cancers... (Source: Health News from Medical News Today)

Epstein-Barr virus nuclear antigen-1 B-cell epitopes in multiple sclerosis twins

Multiple Sclerosis — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: In a study that controls for confounders, our data focus an EBNA-1 specificity that may be associated with MS pathogenesis. (Source: Multiple Sclerosis)

NIH scientists outline steps toward Epstein-Barr virus vaccine

EurekAlert! - Medicine and Health — Wed, 02 Nov 2011 04:00:00 +0100

(NIH/National Institute of Allergy and Infectious Diseases) Epstein-Barr virus infects nine out of ten people worldwide at some point during their lifetimes. Infections in early childhood often cause no disease symptoms, but people infected during adolescence or young adulthood may develop infectious mononucleosis, a disease characterized by swollen lymph nodes, fever and severe fatigue. (Source: EurekAlert! - Medicine and Health)

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Is the addition of a standard HIV educational comment to virology laboratory reports effective in changing requesting behaviour?

Journal of Clinical Virology — Thu, 13 Oct 2011 04:00:00 +0100

Abstract: Background: It is not known whether the addition of general educational comments to virology laboratory reports can influence the requesting behaviour of practitioners.Objectives: To establish if there is any change in requesting behaviour after the addition of a standard comment to virology laboratory reports highlighting the need to include HIV testing when investigating patients presenting with a glandular fever (GF)-like illness.Study design: A standard comment to encourage inclusion of HIV testing was added to all GF screening reports from April 2010. The proportion of GF screening samples with concomitant HIV test requests before and after the introduction of the standard comment were compared over a 1 year period.Results: A significant increase in concomitant HIV requests ...

Acute dacryocystitis associated with epstein-barr virus infection.

Orbit — Sat, 01 Oct 2011 04:00:00 +0100

We present two further children with acute dacryocystitis and clinical and laboratory features of Epstein-Barr Virus related infectious mononucleosis. Both were treated with systemic antibiotics and one child additionally required surgical drainage of a lacrimal sac abscess. Both children made a complete recovery without any lacrimal symptoms. Acute dacryocystitis is uncommon in children without a history of congenital nasolacrimal duct obstruction, and an underlying systemic condition such as infectious mononucleosis should be suspected. In such patients, dacryocystitis can be expected to resolve without symptoms of nasolacrimal duct obstruction and dacryocystorhinostomy is seldom required. PMID: 21957956 [PubMed - in process] (Source: Orbit)

Use of the absolute lymphocyte count in the diagnosis of infectious mononucleosis

Clinical Otolaryngology — Sat, 01 Oct 2011 04:00:00 +0100

(Source: Clinical Otolaryngology)

The son I thought I wouldn't live to see: Father given heart transplant six weeks before Oscar's birth

the Mail online | Health — Fri, 23 Sep 2011 08:54:07 +0100

Ben Knight (pictured), of Simonstone, Lancashire, was diagnosed with cardiomyopathy, a swelling of the heart muscle, ten years ago after a bout of glandular fever. (Source: the Mail online | Health)

Epstein-Barr virus and multiple sclerosis

Journal of Neurology, Neurosurgery and Psychiatry — Thu, 08 Sep 2011 04:00:00 +0100

This review of the considerable evidence linking Epstein–Barr virus (EBV) infection to risk and disease progression in multiple sclerosis (MS) builds on the background to the virus and its interactions with the human host available in the online supplement (see supplement, available online only). The evidence for a similarity in the geographic patterns of occurrence of MS and EBV infection (with infectious mononucleosis or EBV specific serology used as surrogate markers), when reviewed critically, is very limited. There is strong evidence however that people with MS are more likely to report a past history of infectious mononucleosis (thought to represent initial EBV infection at an older age), and higher titres of EBV specific antibodies are associated with an increased risk of deve...

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Sudden Death and Angelman Syndrome.

Journal of Forensic Sciences — Thu, 18 Aug 2011 23:00:00 +0100

Authors: Herbst J, Byard RW Abstract Angelman syndrome is a condition characterized by developmental delay due to abnormalities in the maternally derived chromosome 15q11-q13. Typical features include impaired expressive language, an ataxic gait, and seizures. Hyperactivity may result in accidental bruises and abrasions, raising issues of possible inflicted injury. A fascination with water may predispose to drowning. A 5-year-old boy with an established diagnosis of Angelman syndrome is reported who died of upper airway obstruction due to massively enlarged tonsils complicating infectious mononucleosis. Assessment of the severity of underlying illness in developmentally delayed children may be difficult due to failure to vocalize worsening symptoms and distress. In addition, si...

Cardiac Complications and Immunophenotypic Profile of Infectious Mononucleosis Syndrome in Children.

Indian Pediatrics — Mon, 15 Aug 2011 04:00:00 +0100

CONCLUSIONS: In infectious mononucleosis syndrome, asymptomatic pericardial effusion could be associated with very low CD4+/CD8+ ratio (< 0.5). Further studies would extend and confirm such an association. PMID: 21992856 [PubMed - as supplied by publisher] (Source: Indian Pediatrics)

Palisaded neutrophilic and granulomatous dermatitis: A presenting sign of sarcoidosis?

Journal of the American Academy of Dermatology — Fri, 12 Aug 2011 16:59:47 +0100

To the Editor: A 43-year-old Caucasian man with no significant medical conditions presented with a 10-day history of a cutaneous eruption on his left upper extremity progressing to his right arm, posterior neck, and upper back. The lesions consisted of 3- to 30-mm blanching, nonpruritic erythematous annular papules and plaques with indurated borders. Some lesions exhibited targetoid features with dusky, violaceous centers and central clearing ().Two weeks before the eruption, he experienced fever, nonproductive cough, conjunctival injection, and arthralgias for 10 days. The patient demonstrated a mild leukocytosis (white blood cell count, 11,700 cells/mm3) and an elevated erythrocyte sedimentation rate of 70 mm/h (normal, 0-15 mm/h). Serum evaluation for mononucleosis, mycoplasma cold agg...

Secular and seasonal trends of infectious mononucleosis among young adults in Israel: 1978–2009

European Journal of Clinical Microbiology and Infectious Diseases — Tue, 02 Aug 2011 05:53:15 +0100

Abstract Recent evidence that infectious mononucleosis (IM) may be sexually transmitted prompted the present analysis. Infectious mononucleosis is a notifiable disease in the Israel Defense Forces (IDF). For the present study, the archives of the IDF were reviewed for all cases of IM from January 1, 1978 to December 31, 2009, and the rates were calculated. Annual rates decreased from 2.99 cases per 1,000 in 1979 to a low of 0.38 cases per 1,000 young adults in 1987. Between 2002 and 2009, the average annual rate was 0.88 cases per 1,000, just half the average rate of 1.69 observed between 1989 and 2001. Average monthly rates varied from a low of 0.90 cases per 10,000 in February to a high of 1.50 cases per 10,000 in August. The difference in the average rates between winte...

Autonomic Symptoms at Baseline and Following Infectious Mononucleosis in a Prospective Cohort of Adolescents [Research Letters]

Archives of Pediatrics — Sun, 31 Jul 2011 23:00:00 +0100

(Source: Archives of Pediatrics)

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Return to contact sports following infectious mononucleosis: The role of serial ultrasonography.

Ear, Nose and Throat Journal — Sun, 31 Jul 2011 23:00:00 +0100

Authors: O'Connor TE, Skinner LJ, Kiely P, Fenton JE Abstract Splenic rupture is a rare but potentially fatal complication of infectious mononucleosis. Athletes returning to contact sports following infectious mononucleosis are at potential risk of splenic rupture secondary to abdominal trauma. No clear consensus exists as to when it is safe to allow these athletes to return to contact sports. Suggested periods of abstinence have ranged from 2 weeks to 6 months. We outline our experiences with the use of abdominal ultrasonography at 1 month after the diagnosis of infectious mononucleosis as a means of determining when athletes can safely return to contact sports. Our study group was made up of 19 such patients (mean age: 16.7 yr). We found that 16 of these patients (84%) had normal...

Antibody titers against EBNA1 and EBNA2 in relation to Hodgkin lymphoma and history of infectious mononucleosis

International Journal of Cancer — Sat, 30 Jul 2011 15:20:04 +0100

AbstractA role for Epstein Barr virus (EBV) in Hodgkin lymphoma (HL) pathogenesis is supported by the detection of EBV genome in about one‐third of HL cases, but is not well defined. We previously reported that an elevated pre‐diagnosis antibody titer against EBV nuclear antigens (EBNA) was the strongest serologic predictor of subsequent HL. For the present analysis, we measured antibody levels against EBNA components EBNA1 and EBNA2 and computed their titer ratio (anti‐EBNA1:2) in serum samples from HL cases and healthy siblings. We undertook this analysis to examine whether titer patterns atypical of well‐resolved EBV infection, such as an anti‐EBNA1:2 ratio ≤1.0, simply reflect history of infectious mononucleosis (IM), an HL risk factor, or independently predict HL risk. Par...

Updated for the 2012 edition of CMDT: Chapter 32. Viral and Rickettsial Infections

AccessMedicine Updates — Thu, 28 Jul 2011 18:40:53 +0100

Herpesviruses cause a wide spectrum of human disease. Eight identified human herpesviruses (HHV) include herpes simplex virus (HSV) (type 1), HSV (type 2), varicella zoster virus (VZV) (type 3), Epstein–Barr infectious mononucleosis virus (type 4), and cytomegalovirus (CMV) (type 5). (Source: AccessMedicine Updates)

Current and past Epstein-Barr virus infection in risk of initial CNS demyelination

Neurology — Sun, 24 Jul 2011 23:00:00 +0100

Conclusion: Past infection with EBV, but not current EBV DNA load in whole blood, is significantly associated with increased FCD risk. These associations appear to be modified by immune-related gene variants. (Source: Neurology)

New Glandular Fever, Gene And MS Links, Australia

Health News from Medical News Today — Fri, 22 Jul 2011 12:00:00 +0100

Scientists working on the Australian-based Ausimmune Study have discovered that a past infection with glandular fever, also known as the Epstein-Barr virus (EBV), combined with genetic variations in the immune system can greatly increase a person's risk of developing multiple sclerosis (MS). Associate Professor Robyn Lucas from the College of Medicine, Biology and Environment at the Australian National University said the research could lead to new therapeutic and preventative strategies for MS directed at relevant components of the immune system... (Source: Health News from Medical News Today)

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Risk of MS linked to past history of glandular fever

Multiple Sclerosis Trust — Thu, 21 Jul 2011 23:00:00 +0100

An Australian study has provided more evidence on the link between infection with EBV, certain genes and developing MS. (Source: Multiple Sclerosis Trust)

Glandular fever linked to MS risk: study

Multiple Sclerosis Trust — Thu, 21 Jul 2011 23:00:00 +0100

People who have had glandular fever face an increased risk of developing multiple sclerosis (MS), scientists have discovered. (Source: Multiple Sclerosis Trust)

Hospitalist Rounds: Nausea, fever, and weight loss.

The Journal of Family Practice — Thu, 30 Jun 2011 23:00:00 +0100

Authors: Ferrara M, Bernheisel C The patient's monospot test was positive, but the clinical picture didn't fully match infectious mononucleosis. We dug further. PMID: 21731914 [PubMed - in process] (Source: The Journal of Family Practice)

B-cell polyclonal activation and Epstein-Barr viral abortive lytic cycle are two key features in acute infectious mononucleosis

Journal of Clinical Virology — Sun, 19 Jun 2011 23:00:00 +0100

Conclusion: The in vivo terminal-B-cell differentiation into plasma cells could unmask EBV B-cell reservoir to specific cytotoxic T-cell response and combined with a predominant abortive functional-EBV-reservoir, strongly contribute to rapid decay of cellular EBV reservoir in AIM. (Source: Journal of Clinical Virology)

[A young girl with abdominal pain.]

Tidsskrift for den Norske Laegeforening — Thu, 16 Jun 2011 23:00:00 +0100

We present a 12-year-old girl who was admitted to hospital with abdominal pain, fever and nausea, but she also complained of cough, weight loss and night sweat. Investigations revealed multiple and randomly distributed lung nodules, impaired lung function, meningitis and multiple small brain lesions, consistent with tuberculomas. The polymerase chain reaction was positive for Mycobacterium tuberculosis in sputum. Cultures of sputum and cerebrospinal fluid were also positive and confirmed miliary tuberculosis with concomitant meningitis. The result of the Mantoux test was 13 mm and that of the Quantiferon-TB Gold was 5.17 IU/ml. She was given four antituberculous drugs (isoniazide, rifampicin, pyrazinamide and ethambutol) for two months and two drugs (isoniazide and rifampicin) for an addit...

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Concurrent diphtheria and infectious mononucleosis: difficulties for management, investigation and control of diphtheria in developing countries.

Journal of Medical Microbiology — Wed, 15 Jun 2011 23:00:00 +0100

We report a case of concurrent diphtheria and infectious mononucleosis in a Brazilian 11-year-old child. Two days after started the specific treatment for diphtheria the case was discharged following clinical recovery. This case highlights the difficulties to diagnose diphtheria clinically in partially immunized individuals and for management and control of diphtheria in developing countries. PMID: 21680765 [PubMed - as supplied by publisher] (Source: Journal of Medical Microbiology)

Isoniazid/rifampicin: Encephalopathy and mononucleosis syndrome (first report with rifampicin): case report

Reactions — Thu, 26 May 2011 16:32:02 +0100

(Source: Reactions)

Viral Reactivation and Drug Rash: Causal or Casual Association?

The American Journal of Medicine — Tue, 24 May 2011 19:43:35 +0100

I read with interest the article, “Drug Rash with Eosinophilia and Systemic Symptoms Syndrome Associated with Clindamycin,” by Tian et al. However, the authors may have missed the opportunity to address an important issue on viral reactivation or persistent viral infection in the pathogenesis of drug rash with eosinophilia and systemic symptoms syndrome, more so in the wake of a recent episode of infectious mononucleosis in the patient. (Source: The American Journal of Medicine)

T-cell receptor gene rearrangement in Epstein–Barr virus infectious mononucleosis

Medical Oncology — Tue, 24 May 2011 05:52:34 +0100

This report describes the case of a previously healthy young man who presented with fever, pharyngitis, cervical lymphadenopathy, lymphocytosis, and severe thrombocytopenia. Serological tests for Epstein–Barr virus were diagnostic of a primary Epstein–Barr virus infectious mononucleosis but severe thrombocytopenia aroused the suspicion of a lymphoproliferative disease. T-cell receptor gene analysis performed on peripheral and bone marrow blood revealed a T-cell receptor γ-chain rearrangement without the evidence of malignancy using standard histologic and immunophenotipe studies. Signs and symptoms of the infectious disease, blood count, and T-cell receptor gene rearrangement resolved with observation without the evidence of emergence of a lymphoproliferative disease. In the con...

Geography of hospital admissions for multiple sclerosis in England and comparison with the geography of hospital admissions for infectious mononucleosis: a descriptive study

Journal of Neurology, Neurosurgery and Psychiatry — Thu, 05 May 2011 23:00:00 +0100

Conclusions The results show the continued existence of a latitude gradient for MS in England and show a correlation with the distribution of IM. The data have implications for healthcare provision, because lifetime costs of MS exceed £1 million per case in the UK, as well as for studies of disease causality and prevention. (Source: Journal of Neurology, Neurosurgery and Psychiatry)

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The Cochrane Library and the Treatment of Sore Throat in Children and Adolescents: An Overview of Reviews

Evidence-Based Child Health: A Cochrane Review Journal — Fri, 22 Apr 2011 21:49:32 +0100

ConclusionsEvidence from the CDSR suggests that antibiotics provide only modest improvements in symptoms of sore throat in children and adolescents. If antibiotics are prescribed, macrolides are less ideal compared to other agents, and there is some evidence that a short course of a newer cephalosporin may be slightly better than a standard course of penicillin. Any potential benefit of antibiotic treatment must be weighed against the cost of treatment and the possibility of adverse effects. Children with a past history of rheumatic fever or those living in a region with a high prevalence of this condition are more likely to benefit from antibiotics than those without these risk factors. Oral corticosteroids can decrease sore throat symptoms within the first day and may be helpful for chil...

Vitamin D and common virus link found

Multiple Sclerosis Society Press Releases — Wed, 20 Apr 2011 01:00:00 +0100

Research published today has suggested a direct link between exposure to sunlight (UVB) and Epstein Barr virus (which can develop into glandular fever) in determining the risk of developing MS. (Source: Multiple Sclerosis Society Press Releases)

Common Virus, Low Sunlight Exposure May Increase Risk Of MS

Health News from Medical News Today — Tue, 19 Apr 2011 07:00:00 +0100

New research suggests that people who are exposed to low levels of sunlight coupled with a history of having a common virus known as mononucleosis may be at greater odds of developing multiple sclerosis (MS) than those without the virus. The research is published in the April 19, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology. "MS is more common at higher latitudes, farther away from the equator," said George C. Ebers, MD, with the University of Oxford in the United Kingdom and a member of the American Academy of Neurology... (Source: Health News from Medical News Today)

Virus + Low Sun Exposure Ups MS Risk

Medical Headlines From Ivanhoe.com — Tue, 19 Apr 2011 05:00:00 +0100

(Ivanhoe Newswire) -- People who are exposed to low levels of sunlight coupled with a history of having a common virus known as mononucleosis may be at greater odds of developing multiple sclerosis (MS), according to this study. (Source: Medical Headlines From Ivanhoe.com)

Virus and low sunlight 'raises multiple sclerosis risk'

Multiple Sclerosis Trust — Mon, 18 Apr 2011 23:00:00 +0100

Low levels of sunlight coupled with glandular fever could increase the risk of developing multiple sclerosis (MS), say researchers. (Source: Multiple Sclerosis Trust)

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Can Common Virus, Lack of Sunlight Boost MS Risk?

The Doctors Lounge - Infections — Mon, 18 Apr 2011 21:00:00 +0100

Preliminary study suggests link to virus behind mononucleosis (Source: The Doctors Lounge - Infections)

Sun exposure, mono linked to multiple sclerosis

Reuters: Health — Mon, 18 Apr 2011 20:18:19 +0100

NEW YORK (Reuters Health) - No one is sure what causes multiple sclerosis, but a preliminary study out Monday hints that a combination of low sun exposure and the "kissing disease" mononucleosis could raise a person's risk for the condition. (Source: Reuters: Health)

Can Common Virus, Lack of Sunlight Boost MS Risk?

MedlinePlus Health News — Mon, 18 Apr 2011 20:00:00 +0100

Preliminary study suggests link to virus behind mononucleosis Source: HealthDay Related MedlinePlus Pages: Infectious Mononucleosis, Multiple Sclerosis, Sun Exposure (Source: MedlinePlus Health News)

Lifecoach: Is it possible for glandular fever to come back?

Telegraph Health — Mon, 18 Apr 2011 15:53:52 +0100

Our health experts answer your questions on glandular fever, smoothies and osteoperosis (Source: Telegraph Health)

Mono, Lack of Sun Linked to MS

WebMD Health — Mon, 18 Apr 2011 05:00:00 +0100

Having a history of mononucleosis and low levels of sun exposure appear to be risk factors for multiple sclerosis. (Source: WebMD Health)

Study: Common virus + low sunlight exposure may increase risk of MS

EurekAlert! - Infectious and Emerging Diseases — Mon, 18 Apr 2011 04:00:00 +0100

(American Academy of Neurology) New research suggests that people who are exposed to low levels of sunlight coupled with a history of having a common virus known as mononucleosis may be at greater odds of developing multiple sclerosis than those without the virus. The research is published in the April 19, 2011, print issue of Neurology, the medical journal of the American Academy of Neurology. (Source: EurekAlert! - Infectious and Emerging Diseases)

Relationship of UV exposure to prevalence of multiple sclerosis in England

Neurology — Sun, 17 Apr 2011 23:00:00 +0100

Conclusions: UVB exposure and IM together can explain a substantial proportion of the variance of MS. The effect of UVB on generating vitamin D seems the most likely candidate for explaining its relationship with MS. There is a pressing need to investigate the role of vitamin D and EBV and how they might interact to influence MS risk to identify potential prevention strategies. (Source: Neurology)

Role of the HLA System in the Association Between Multiple Sclerosis and Infectious Mononucleosis [Original Contribution]

Archives of Neurology — Sun, 10 Apr 2011 23:00:00 +0100

Conclusion HLA-DRB1*01:01 is protective against developing MS; thus, a common genetic basis between IM and MS is not supported. (Source: Archives of Neurology)

Environmental triggers of multiple sclerosis

FEBS Letters — Thu, 07 Apr 2011 04:00:00 +0100

Abstract: Multiple sclerosis is a chronic immune-mediated disease of the central nervous system that develops in young adults with a complex genetic predisposition. Similar to other autoimmune disease, HLA-DR and -DQ alleles within the HLA class II region on chromosome 6p21 are by far the strongest risk-conferring genes. Less robust susceptibility effects have been reported for non-MHC related genetic variants. Improvements in the design of epidemiological studies helped to identify consistent environmental risk-associations such as the increased susceptibility for MS in individuals with a history of infectious mononucleosis, a symptomatic primary infection with the human γ-herpesvirus Epstein–Barr virus (EBV). Sun exposure and serum vitamin D levels are emerging non-infectious environm...

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EBV-Associated Polymorphic Posttransplant Lymphoproliferative Disorder Presenting as Gingival Ulcers

International Journal of Surgical Pathology — Wed, 06 Apr 2011 23:00:00 +0100

Posttransplant lymphoproliferative disorders (PTLDs) present a wide clinicopathological spectrum, varying from the usual Epstein-Barr virus (EBV)-driven infectious mononucleosis-type polyclonal proliferations to EBV-positive or EBV-negative proliferations indistinguishable from overt lymphomas that occur in immunocompetent individuals. PTLDs characteristically have a predilection for extranodal sites and association with EBV.These disorders are usually B-cell type, although T-cell and rare cases involving both T- and B-cell types have also been described. The initial treatment consists in decreasing the immnosupressive therapy, usually with favorable results. The authors report on a rare case of a 19-year-old girl, with post—renal transplantation EBV-associated polymorphic lymphoprol...

Performance of new enzyme-linked fluorescent assays for detection of Epstein-Barr virus specific antibodies in routine diagnostics.

Wiener Klinische Wochenschrift — Wed, 30 Mar 2011 23:00:00 +0100

CONCLUSIONS: The new VIDAS(®) assays can be an alternative to IFA testing especially in high-throughput laboratories. Full automation of EBV serological diagnostis by the new VIDAS assays is of major importance for routine diagnostic laboratories. PMID: 21451951 [PubMed - as supplied by publisher] (Source: Wiener Klinische Wochenschrift)

Unusual MRI findings in an immunocompetent patient with EBV encephalitis: a case report

BioMed Central — Thu, 24 Mar 2011 00:00:00 +0100

Conclusion: This report demonstrates that EBV in an immunocompetent adult can present with diffuse, reversible brain white matter involvement in the acute phase of mononucleosis. Moreover, our case suggests that a negative DWI sequence is associated with a favorable improvement in severe EBV CNS infection. More extensive studies are needed to assess what other instrumental data can help to distinguish viral lesions from other causes in the acute phase of disease. (Source: BioMed Central)

Clonal origin of Epstein-Barr virus (EBV)-infected T/NK-cell subpopulations in EBV-positive T/NK-cell lymphoproliferative disorders of childhood

Journal of Clinical Virology — Mon, 07 Mar 2011 00:00:00 +0100

Conclusions: A single EBV clonotype may infect multiple NK-cell and T-cell subsets of patients with EBV+LPD of childhood. CD34+stem cells are spared, suggesting infection of more differentiated elements. (Source: Journal of Clinical Virology)

An updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis

Neurological Conditions Specialist Library — Tue, 01 Mar 2011 14:16:49 +0100

Background: Multiple sclerosis (MS) appears to develop in genetically susceptible individuals as a result of environmental exposures. Epstein-Barr virus (EBV) infection is an almost universal finding among individuals with MS. Symptomatic EBV infection as manifested by infectious mononucleosis (IM) has been shown in a previous meta-analysis to be associated with the risk of MS, however a number of much larger studies have since been published. (Source: Neurological Conditions Specialist Library)

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New aspects of drug-induced hypersensitivity syndrome.

Herpes — Tue, 01 Mar 2011 00:00:00 +0100

Authors: Tohyama M, Hashimoto K Drug-induced hypersensitivity syndrome (DIHS) is caused by a limited number of specific drugs and is characterized by late onset, infectious mononucleosis-like symptoms, and herpesvirus 6 (HHV-6) reactivation. Recently, the involvement of herpes viruses other than HHV-6, such as Epstein-Barr virus and cytomegalovirus, has been reported. Many approaches have been used to analyze the pathological mechanism, and have revealed new aspects of DIHS. Here, we focused on three key recent findings regarding DIHS: (i) overlap between DIHS and Stevens-Johnson syndrome/toxic epidermal necrolysis; (ii) the relevance of Epstein-Barr virus in the development of infectious mononucleosis-like symptoms of DIHS; and (iii) roles of monomyeloid precursors increased in the bl...

Maternal and perinatal factors associated with hospitalised infectious mononucleosis in children, adolescents and young adults: record linkage study

BMC Infectious Diseases — Mon, 28 Feb 2011 00:00:00 +0100

Background: There is current interest in the role of perinatal factors in the aetiology of diseases that occur later in life. Infectious mononucleosis (IM) can follow late primary infection with Epstein-Barr virus (EBV), and has been shown to increase the risk of multiple sclerosis and Hodgkin's disease. Little is known about maternal or perinatal factors associated with IM or its sequelae. Methods: We investigated perinatal risk factors for hospitalised IM using a prospective record-linkage study in a population in the south of England. The dataset used, the Oxford record linkage study (ORLS), includes abstracts of birth registrations, maternities and in-patient hospital records, including day case care, for all subjects in a defined geographical area. From these sources, we identified ca...

UB40 former frontman Ali Campbell on his road back from glandular fever

the Mail online | Health — Wed, 16 Feb 2011 16:34:41 +0100

As singer Ali Campbell was putting the final touches to his new album, his legs suddenly buckled from under him and he collapsed on the recording studio floor. (Source: the Mail online | Health)

Infectious mononucleosis with atypical manifestations accompanied by transient IgM antibody response for cytomegalovirus

Journal of Infection and Chemotherapy — Wed, 16 Feb 2011 06:54:06 +0100

We report an unusual case of infectious mononucleosis in a 34-year-old immunocompetent adult. Epidemiological studies indicate that the average age of primary EBV infection in developed countries is increasing. IM with atypical presentation will be a diagnostic challenge in the future as the number of EBV-naïve adults increases. Content Type Journal ArticlePages 1-3DOI 10.1007/s10156-011-0221-6Authors Jun Nishikawa, Department of Gastroenterology and Hematology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194 JapanHisashi Funada, Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194 JapanTakako Miyazaki, Department of...

Immune defence against EBV and EBV-associated disease.

Current Opinion in Immunology — Mon, 24 Jan 2011 00:00:00 +0100

Authors: Long HM, Taylor GS, Rickinson AB Epstein-Barr virus (EBV), a B-lymphotropic herpesvirus widespread in the human population and normally contained as an asymptomatic infection by T cell surveillance, nevertheless causes infectious mononucleosis and is strongly linked to several types of human cancer. Here we describe new findings on the range of cellular immune responses induced by EBV infection, on viral strategies to evade those responses and on the links between HLA gene loci and EBV-induced disease. The success of adoptive T cell therapy for EBV-driven post-transplant lymphoproliferative disease is stimulating efforts to target other EBV-associated tumours by immunotherapeutic means, and has reawakened interest in the ultimate intervention strategy, a prophylactic EBV vacci...

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Epstein Barr Virus hepatitis.

European Journal of Internal Medicine — Sun, 23 Jan 2011 17:46:06 +0100

Authors: Kofteridis DP, Koulentaki M, Valachis A, Christofaki M, Mazokopakis E, Papazoglou G, Samonis G Epstein-Barr Virus (EBV) infection has the potential to establish life-long, benign infections in their hosts. Although biochemical evidence of hepatocellular damage is common, jaundice is uncommon and complete recovery is the rule. The present study describes clinical characteristics and changes of liver function tests during the course of infectious mononucleosis. PMID: 21238898 [PubMed - in process] (Source: European Journal of Internal Medicine)

Epidemiologic and clinical characteristics of infectious mononucleosis associated with Epstein-Barr virus infection in children in Beijing, China.

World Journal of Pediatrics : WJP — Thu, 20 Jan 2011 18:46:02 +0100

Authors: Gao LW, Xie ZD, Liu YY, Wang Y, Shen KL infectious mononucleosis (IM) is a self-limited disease, but a few cases may have severe complications. This retrospective study was to explore the epidemiologic and clinical characteristics of IM associated with Epstein-Barr virus infection (EBV-IM) in children. PMID: 21191775 [PubMed - in process] (Source: World Journal of Pediatrics : WJP)

[A young man with mononucleosis and swelling of the right eye.]

Tidsskrift for den Norske Laegeforening — Fri, 07 Jan 2011 00:00:00 +0100

We present a case report (with pan sinusitis and grave local complications) from the ear, nose and throat department in St. Olav's University Hospital in Trondheim, Norway. PMID: 21233887 [PubMed - as supplied by publisher] (Source: Tidsskrift for den Norske Laegeforening)

Progress and problems in understanding and managing primary epstein-barr virus infections.

Clinical Microbiology Reviews — Sat, 01 Jan 2011 00:00:00 +0100

Authors: Odumade OA, Hogquist KA, Balfour HH Summary: Epstein-Barr virus (EBV) is a gammaherpesvirus that infects a large fraction of the human population. Primary infection is often asymptomatic but results in lifelong infection, which is kept in check by the host immune system. In some cases, primary infection can result in infectious mononucleosis. Furthermore, when host-virus balance is not achieved, the virus can drive potentially lethal lymphoproliferation and lymphomagenesis. In this review, we describe the biology of EBV and the host immune response. We review the diagnosis of EBV infection and discuss the characteristics and pathogenesis of infectious mononucleosis. These topics are approached in the context of developing therapeutic and preventative strategies. PMID: 2123...

Soluble CD30: A serum marker for Epstein–Barr virus‐associated lymphoproliferative diseases

Journal of Medical Virology — Thu, 23 Dec 2010 04:21:17 +0100

This study demonstrates that sCD30 and EBV DNA levels can be used as potential markers for diagnosis of IM and PTLD. J. Med. Virol. 83:311–316, 2011. © 2010 Wiley‐Liss, Inc. (Source: Journal of Medical Virology)

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Tonsillar CD4+FOXP3+ T-regulatory cell dynamics in primary EBV infection

Immunologic Research — Thu, 02 Dec 2010 07:09:39 +0100

Abstract CD8+ lymphocytosis is recognized as the primary immunopathological response generated in primary EBV infection that may manifest itself as a benign lymphoproliferative disorder, infectious mononucleosis (IM). While CD4+FOXP3+ T-regulatory cells (Treg cells) are well accepted to inhibit T-cell responses, it is puzzling why massive expansion of CD8+ lymphocytes still occurs despite CD4+FOXP3+ Treg cells are localized in tonsils, which are the port of entry of the virus. Understanding the interplay between the virologic and immunologic events that take place in tonsils in primary EBV infection is necessary to comprehend why IM preferentially develops in adolescents and the dynamics of CD4+ Treg cell change that may occur in virus/pathogen infection in a broader setting....

Kikuchi-Fujimoto disease: an unusual association with acute renal failure.

Braz J Infect Dis — Wed, 01 Dec 2010 00:00:00 +0100

Authors: Silva AF, Focaccia R, Oliveira AC, Sementilli A, Reis GF Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis of unknown etiopathogenesis, is a self-limited disease which frequently appears as feverish lymphadenomegaly, thus creating the need for differential diagnosis with lymphoma, systemic lupus erythematosus (SLE), infectious mononucleosis, cat-scratch disease, and toxoplasmosis with lymphonodal impairment. However, there are cases in which it may evolve with complications such as aseptic meningitis, cerebellar ataxia, and aseptic myocarditis. We are presenting a case of a 24-year-old man who had an initial picture of arthralgia, evening fever and adenomegaly. Kikuchi disease was diagnosed through lymph node biopsy with immunohistochemistry and evo...

Serum Epstein–Barr virus (EBV) viral load can be a complementary sensitive test in primary Epstein–Barr virus infection

Journal of Clinical Virology — Mon, 29 Nov 2010 00:00:00 +0100

In the recent review by Gärtner and Preiksaitis on Epstein–Barr virus (EBV) viral load determination in clinical virology, the authors briefly discussed the value of serum EBV DNA detection in acute infectious mononucleosis (IM) in immunocompetent patients. The diagnosis of IM is routinely based on serology and the serological gold standard for the diagnosis of an acute EBV infection remains an IgG seroconversion. This is however frequently not observed since often, at the first time of presentation of the patient, IgG antibodies are already positive or, from a more practical point of view, frequently no follow-up sample is available. Therefore, IM diagnostics routinely involves using a combination of different serological markers, e.g. heterophile antibodies, viral capsid antigen (VCA)...

[Proximal radial nerve palsy resulting from acute Epstein-Barr virus infection.]

Der Chirurg — Sat, 20 Nov 2010 00:00:00 +0100

Authors: Ring A, Langer S, Harati K, Steinau HU, Steinstraesser L Irreparable peripheral nerve palsies rarely present as neurological complications in infectious mononucleosis. A case of isolated proximal radial nerve palsy resulting from an acute infection with Epstein-Barr virus is reported. The hand function was restored by multiple tendon transfer surgery. PMID: 21103854 [PubMed - as supplied by publisher] (Source: Der Chirurg)

Disseminated toxoplasmosis: an atypical presentation in an immunocompetent patient.

Tropical Doctor — Tue, 09 Nov 2010 00:00:00 +0100

We report an unusual severe case of disseminated toxoplasmosis complicated with meningitis and pneumonia in a previously 41-year-old healthy Brazilian man. Toxoplasmosis should be included in the differential diagnosis of acute ferbrile diseases due to the non-specific clinical symptoms and the possibility of severe outcome. PMID: 21062937 [PubMed - as supplied by publisher] (Source: Tropical Doctor)

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Infectious mononucleosis-linked HLA class I single nucleotide polymorphism is associated with multiple sclerosis

Multiple Sclerosis — Mon, 01 Nov 2010 00:00:00 +0100

Conclusions: HLA class I single nucleotide polymorphism rs6457110 is associated with infectious mononucleosis and multiple sclerosis, independent of the major class II allele, supporting the hypothesis that shared genetics may contribute to the association between infectious mononucleosis and multiple sclerosis. (Source: Multiple Sclerosis)

Primary Epstein-Barr virus infection in 2-year-old children: report of 3 cases.

The Turkish Journal of Pediatrics — Mon, 01 Nov 2010 00:00:00 +0100

In conclusion, EBV capsid immunoglobulin (Ig)M antibodies and atypical lymphocytes are useful diagnostic measurements in very young children with symptoms suggestive of IM. PMID: 21428202 [PubMed - in process] (Source: The Turkish Journal of Pediatrics)

Genital Ulcers Associated with Epstein-Barr Virus Infection (Ulcus Vulvae Acutum).

Acta Derm Venereol A... — Fri, 29 Oct 2010 00:00:00 +0100

We describe here a case of an adolescent virgin with multiple, deep genital ulcers associated with acute infectious mononucleosis. The diagnosis was supported by the clinical symptoms, atypical lymphocytosis, elevated circulating levels of liver enzymes, positive EBV serology, and the detection of EBV in a swab sample and a biopsy specimen by PCR. The virus could not be detected by immunohistochemistry or in situ hybridization. After a short course of methylprednisolone as a supportive treatment, the ulcers healed within one month. No relapse occurred during the 2-year follow-up. Available data relating to the aetiopathogenesis of this condition are reviewed, and we speculate that it may have been caused by percutaneous autoinoculation through cervicovaginal fluid. PMID: 21031278 [PubM...

Impaired Epstein-Barr virus-specific CD8+ T-cell function in X-linked lymphoproliferative disease is restricted to SLAM family-positive B-cell targets

Blood — Wed, 27 Oct 2010 23:00:00 +0100

X-linked lymphoproliferative disease (XLP) is a condition associated with mutations in the signaling lymphocytic activation molecule (SLAM)–associated protein (SAP; SH2D1A). SAP functions as an adaptor, binding to and recruiting signaling molecules to SLAM family receptors expressed on T and natural killer cells. XLP is associated with extreme sensitivity to primary Epstein-Barr virus (EBV) infection, often leading to a lethal infectious mononucleosis. To investigate EBV-specific immunity in XLP patients, we studied 5 individuals who had survived EBV infection and found CD8+ T-cell responses numerically comparable with healthy donors. However, further investigation of in vitro–derived CD8+ T-cell clones established from 2 of these donors showed they efficiently recognized SLAM ...

Health Tip: Signs That You May Have Mono

The Doctors Lounge - Infections — Thu, 14 Oct 2010 14:00:00 +0100

Common symptoms of mononucleosis (Source: The Doctors Lounge - Infections)

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Health Tip: Signs That You May Have Mono

MedlinePlus Health News — Thu, 14 Oct 2010 13:00:00 +0100

Common symptoms of mononucleosis Source: HealthDay Related MedlinePlus Page: Infectious Mononucleosis (Source: MedlinePlus Health News)

Erratum: Infectious Mononucleosis

New England Journal of Medicine — Wed, 06 Oct 2010 21:00:22 +0100

New England Journal of Medicine, Volume 363, Issue 15, Page 1486, October 2010. (Source: New England Journal of Medicine)

Challenging the use of the lymphocyte to white cell count ratio in the diagnosis of infectious mononucleosis by analysis of a large cohort of monospot test results

Clinical Otolaryngology — Fri, 01 Oct 2010 00:00:00 +0100

Conclusions: The mean lymphocyte to white cell count ratio is not sufficient to diagnose or exclude infectious mononucleosis. Thus, this study does not confirm the conclusions of earlier studies. (Source: Clinical Otolaryngology)

Robert W. McCollum, Who Studied Viral Diseases, Dies at 85

NYT Health — Tue, 28 Sep 2010 17:27:29 +0100

Dr. McCollum made significant contributions to the understanding of viral diseases, including polio, hepatitis and mononucleosis. (Source: NYT Health)

Robert W. McCollum, Dean of Dartmouth Medical School, Dies at 85

NYT Health — Sun, 26 Sep 2010 03:55:36 +0100

Dr. McCollum made significant contributions to the understanding of viral diseases, including polio, hepatitis and mononucleosis. (Source: NYT Health)

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Measurement of Epstein-Barr virus DNA load using a novel quantification standard containing two EBV DNA targets and SYBR Green I dye

BioMed Central — Tue, 21 Sep 2010 23:00:00 +0100

Conclusion: Two sensitive and specific real-time PCR assays using SYBR Green I dye and a single quantification standard containing two EBV DNA targets, were developed for the detection and measurement of EBV DNA load in a variety of clinical samples. These assays have application in the investigation of EBV-related illnesses in immunocompromised individuals. (Source: BioMed Central)

Coinfection with EBV/CMV and other respiratory agents in children with suspected infectious mononucleosis

Virology Journal — Mon, 20 Sep 2010 23:00:00 +0100

Conclusion: Our study suggests that there is a high incidence of multipathogen infections in children admitted with EBV/CMV primary infection and that the distribution of these pathogens is not random. (Source: Virology Journal)

Teens With Chronic Fatigue May Try Too Hard to Keep up

Medscape Infectious Diseases Headlines — Mon, 13 Sep 2010 19:04:48 +0100

Teenagers who've had infectious mononucleosis can be plagued for months or even years with chronic fatigue, investigators say. Reuters Health Information (Source: Medscape Infectious Diseases Headlines)

Postinfectious Fatigue in Adolescents and Physical Activity [Article]

Archives of Pediatrics — Mon, 06 Sep 2010 19:50:34 +0100

Conclusions Adolescents with chronic fatigue syndrome appear to be pushing themselves in an attempt to maintain similar activity levels as their peers, but paying for it in terms of fatigue severity and an increased need for sleep, particularly during the day. (Source: Archives of Pediatrics)

Pediatric Epstein‐Barr Virus Carriers With or Without Tonsillar Enlargement May Substantially Contribute to Spreading of the Virus

The Journal of Infectious Diseases Latest Issue — Sat, 04 Sep 2010 07:04:01 +0100

Conclusions. Pediatric EBV carriers—in particular, those with TE—may considerably contribute to the spreading of EBV in industrialized countries. (Source: The Journal of Infectious Diseases Latest Issue)

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Recent Advances on the Possible Neuroprotective Activities of Epstein-Barr Virus Oncogene BARF1 Protein in Chronic Inflammatory Disorders of Central Nervous System.

Current Neuropharmacology — Wed, 01 Sep 2010 00:00:00 +0100

Authors: Wynne A, Kanwar RK, Khanna R, Kanwar JR Multiple sclerosis and neurodegenerative diseases in which cells of the central nervous system (CNS) are lost or damaged are rapidly increasing in frequency, and there is neither effective treatment nor cure to impede or arrest their destructive course. The Epstein-Barr virus is a human gamma-herpesvirus that infects more than 90% of the human population worldwide and persisting for the lifetime of the host. It is associated with numerous epithelial cancers, principally undifferentiated nasopharyngeal carcinoma and gastric carcinoma. Individuals with a history of symptomatic primary EBV infection, called infectious mononucleosis, carry a moderately higher risk of developing multiple sclerosis (MS). It is not known how EBV infection poten...

Using flow cytometry to screen patients for X-linked lymphoproliferative disease due to SAP deficiency and XIAP deficiency.

Journal of Immunological Methods — Tue, 31 Aug 2010 23:00:00 +0100

Authors: Marsh RA, Bleesing JJ, Filipovich AH X-linked lymphoproliferative disease is a rare congenital immunodeficiency that is most often caused by mutations in SH2D1A, the gene encoding signaling lymphocyte activation molecule (SLAM)-associated protein (SAP). XLP caused by SAP deficiency is most often characterized by fulminant mononucleosis/EBV- associated hemophagocytic lymphohistiocytosis (HLH), lymphoma, and dysgammaglobulinemia. XLP has also been found to be caused by mutations in BIRC4, the gene encoding X-linked inhibitor of apoptosis (XIAP). Patients with XIAP deficiency often present with HLH or recurrent HLH, which may or may not be associated with EBV. XLP is prematurely lethal in the majority of cases. While genetic sequencing can provide a genetic diagnosis of XLP, a mo...

Cardiogenic shock due to citomegalovirus myocarditis: successful clinical treatment

Revista Brasileira de Cirurgia Cardiovascular — Sun, 29 Aug 2010 09:48:14 +0100

CONCLUSION: Potentially curable forms of myocarditis, like M pneumoniae and CMV, for example, can have an initial disproportionate aggression to the myocardium, by the acute inflammatory reaction, that can by itself make worse the damage to the LV function. In our opinion, the blockade of this process by pulsotherapy with steroids can help in the treatment of these patients. We understand that the different scenario of immunosuppressive treatments for the possible auto immunity of the more chronic forms of the presumably post viral cardiomyopathy has been in dispute in the literature, and has stolen the focus from the truly acute cases.OBJETIVO: Doença sistêmica por citomegalovírus (CMV) com miocardite em pessoas saudáveis é raramente referida na literatura, apesar de em maior número...

Antiviral treatment for severe EBV infections in apparently immunocompetent patients

Journal of Clinical Virology — Thu, 26 Aug 2010 23:00:00 +0100

Conclusion: The available data derive from case reports and case series and thus the deduction of conclusions regarding the effect, if any, of antiviral treatment is debatable. However, physicians may consider using antiviral agents in severe manifestations of EBV infections in immunocompetent patients as an adjunct to steroid treatment. (Source: Journal of Clinical Virology)

Infliximab/methotrexate: Cytomegalovirus-induced infectious mononucleosis-like syndrome: case report

Reactions — Tue, 24 Aug 2010 05:51:22 +0100

(Source: Reactions)

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Infectious Mononucleosis

MedicineNet Skin General — Fri, 20 Aug 2010 07:00:00 +0100

Title: Infectious MononucleosisCategory: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 8/20/2010 (Source: MedicineNet Skin General)

Epstein-Barr virus-associated infectious mononucleosis and risk of systemic lupus erythematosus

Rheumatology — Tue, 10 Aug 2010 13:42:41 +0100

Conclusions. EBV-associated IM does not seem to be a risk factor for SLE. The temporal pattern of increased SLE risk in individuals with a negative PB test suggests that some patients who go on to develop SLE may present with unspecific symptoms, for which they may be tested for IM, long in advance of their SLE diagnosis. (Source: Rheumatology)

Lifelong persistent EBV infection of rabbits with EBER1-positive lymphocyte infiltration and mild sublethal hemophagocytosis.

Virus Research — Thu, 05 Aug 2010 23:00:00 +0100

Authors: Kanai K, Takashima K, Okuno K, Kato K, Sano H, Kuwamoto S, Higaki H, Nagata K, Sugihara H, Kato M, Murakami I, Hayashi K Most humans become lifelong carriers of Epstein-Barr virus (EBV) by adulthood. Primary EBV infection in adolescents causes in one to two-third of cases infectious mononucleosis. EBV infection is associated with various diseases, neoplasms and hematological disorders. Recently we reported that EBV can infect rabbits frequently by intravenous, intranasal or/and peroral inoculation, which caused primary EBV infection in rabbits with heterogeneous host reactions. Here we presented follow up data that of six primary EBV-infected rabbits out of seven inoculated intravenously with EBV, two out of six EBV-infected rabbits showed lifetime EBV infection. (1) EBV-DNA w...

Newspath August, 2010 - Heterophilic Antibody Interference in Laboratory Tests: Important for Clinicians and Practicing Pathologists

NewsPath - Pathology News for the Medical Community — Mon, 02 Aug 2010 14:00:00 +0100

Naturally occurring heterophilic antibodies such as those that occur in infectious mononucleosis are known to cause interference in assays in the chemistry laboratory. (Source: NewsPath - Pathology News for the Medical Community)

Challenging the use of the lymphocyte to white cell count ratio in the diagnosis of infectious mononucleosis by analysis of a large cohort of monospot test results.

Clinical Otolaryngology — Sat, 31 Jul 2010 23:00:00 +0100

(Source: Clinical Otolaryngology)

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Original Article: Diagnosis of infectious mononucleosis caused by Epstein–Barr virus in infants

Pediatrics International — Sat, 31 Jul 2010 23:00:00 +0100

Abstract (Source: Pediatrics International)

CCGMP Infectious Disease Chapter 15 - Epstein-Barr Virus (EBV) and Infectious Mononucleosis for the ID Boards

Modern Medicine — Wed, 28 Jul 2010 23:00:00 +0100

(Source: Modern Medicine)

Juvenile myelomonocytic leukaemia: case report

Revista Brasileira de Hematologia e Hemoterapia — Sat, 24 Jul 2010 05:51:14 +0100

We describe the case of a 22-month-old male child, who appeared in the emergency room of Hospital de Clínicas de Porto Alegre because of fever and with a previous diagnosis of mononucleosis made at another Institution. The clinical presentation together with laboratory findings allowed the correct diagnosis. The patient was treated with chemotherapy and underwent hematopoietic stem cell transplantation. (Source: Revista Brasileira de Hematologia e Hemoterapia)

[Acute dacryocystitis complicating primary mononucleosis infection.]

Revue de Stomatologie et de Chirurgie Maxillo-Faciale — Thu, 22 Jul 2010 23:00:00 +0100

DISCUSSION: Dacryocystitis is a rare and little documented complication of EBV infection. Its acute evolution to orbital cellulitis is possible and potentially severe. Its physiopathology is specific. Patients are initially free of chronic stenosis and epiphora, which express acute obstruction of the lachrymal sac due to general lymphoid hyperplasia. PMID: 20656312 [PubMed - as supplied by publisher] (Source: Revue de Stomatologie et de Chirurgie Maxillo-Faciale)

Early and rapid detection of X-linked lymphoproliferative syndrome with SH2D1A mutations by flow cytometry

Cytometry Part B: Clinical Cytometry — Wed, 14 Jul 2010 23:00:00 +0100

X-linked lymphoproliferative syndrome (XLP) is a rare immunodeficiency with extreme vulnerability to Epstein-Barr virus (EBV) infection. It presents with fatal infectious mononucleosis, lymphoproliferative disorder, or dysgammaglobulinemia. The majority of affected males have mutations in the SH2D1A/SLAM-associated protein (SAP) gene. We previously generated an antihuman SAP monoclonal antibody (KST-3) for a flow cytometric assay and described the activation of T cells to be necessary for the flow cytometric assessment of the SAP expression using an FITC-conjugated secondary antibody.Between 2005 and 2008, we recruited 23 male patients with suspected XLP, including mainly EBV-associated hemophagocytic lymphohistiocytosis (HLH), and attempted to evaluate SAP expression in fresh lymphoid cel...

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Lymphocyte and monocyte flow cytometry immunophenotyping as a diagnostic tool in uncharacteristic inflammatory disorders

BMC Infectious Diseases — Mon, 12 Jul 2010 23:00:00 +0100

Conclusion: Immunophenotyping including the combination of the fractions of HLA-DR expressing T cell subpopulations with the level of CD40 on monocytes produces an informative pattern, differentiating between bacterial origin, viral origin and systemic autoimmunity. Furthermore, it provides some indication of a subacute bacterial infection, such as borreliosis or tuberculosis. This flow cytometric method is suitable for clinical diagnostic laboratories, and may help in the assessment of patients with uncharacteristic inflammatory symptoms. (Source: BMC Infectious Diseases)

Combination of Epstein-Barr virus scaffold (BdRF1/VCA-p40) and small capsid protein (BFRF3/VCA-p18) into a single molecule for improved serodiagnosis of acute and malignant EBV-driven disease.

Journal of Virological Methods — Wed, 07 Jul 2010 23:00:00 +0100

Authors: Fachiroh J, Stevens SJ, Haryana SM, Middeldorp JM Current single Epstein-Barr virus (EBV) markers fail to reach 100% sensitivity for serodiagnosis of acute and malignant diseases associated with EBV infection. Previous study had identified immunodominant epitopes of VCA-p40 and VCA-p18, and indicated that these two VCA antigens may have diagnostic value for EBV-related diseases. A recombinant protein of the full length BdRF1 fused to the immunodominant domain of BFRF3 as 6-his tagged protein in E. Coli was developed. The recombinant protein was extracted in 8M urea solution and purified by metal-affinity chromatography yielding a 55kDa product (VCA-p40+18). VCA-p40+18 blot-strips examined for IgM reactivity in infectious mononucleosis samples yielded 100% sensitivity and speci...

Acute infection with Epstein–Barr virus is associated with atherogenic lipid changes

Atherosclerosis — Wed, 30 Jun 2010 23:00:00 +0100

Conclusions: IM is associated with atherogenic changes of lipids and lipoproteins that are partially restored 4 months after its resolution. (Source: Atherosclerosis)

The truth about recovering from a brain injury

Guardian Unlimited Science — Tue, 22 Jun 2010 07:00:17 +0100

Patients share their stories about the long road back to full health after a serious brain injury or illnessA couple of weeks ago, I took a small stepladder into the back garden and climbed a few rungs to fix a light that had stopped working. It doesn't sound much but I glowed with achievement for the rest of the day. Six months earlier, I would have been too unsteady to risk it, and tilting my head to do the repair would have brought on a surge of vertigo and violent sickness. A year ago, I wouldn't even have attempted it – or cared: I was lying on the sofa, intermittently vomiting and being pumped full of industrial-strength antibiotics to see off a mysterious brain infection that had nearly killed me.Last May I was struck down by an abscess on the cerebellum, which controls movement, ...

Ciprofloxacin/sulfasalazine: Generalised rash and hepatitis in a patient with infectious mononucleosis: case report

Reactions — Mon, 21 Jun 2010 05:28:56 +0100

(Source: Reactions)

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[Review] Common misdiagnoses in lymphomas and avoidance strategies

The Lancet Oncology — Mon, 31 May 2010 23:00:00 +0100

Lymphoma diagnosis integrates clinical, morphological, immunophenotypical, and molecular genetic features, as shown in WHO classifications of lymphoid malignancies. Diagnosis of lymphoma is challenging. Reactive lesions such as Kikuchi lymphadenitis, infectious mononucleosis, autoimmune lymphoproliferative syndrome, and immunoglobulin G4-related sclerosing disease can be misdiagnosed as lymphomas. Anaplastic large-cell lymphoma variants that are positive for anaplastic lymphoma kinase, classical Hodgkin's lymphoma variants, and infarcted lymphomas might be misdiagnosed as reactive disorders. Difficulties with classification of lymphomas are also encountered, such as the distinction of classical Hodgkin's lymphoma from anaplastic large-cell lymphoma that is negative for anaplastic lymphoma ...

Return to work following sickness absence due to infectious mononucleosis

Occupational Medicine — Fri, 28 May 2010 08:17:48 +0100

Conclusions Occupational physicians should advise gradual return to work, starting 4 weeks after the onset of the illness, in order to prevent physical deconditioning and prolonged illness. (Source: Occupational Medicine)

Infectious Mononucleosis

New England Journal of Medicine — Tue, 25 May 2010 23:00:00 +0100

A 16-year-old, previously healthy girl presents with a several-day history of fever, sore throat, and malaise. She appears very tired and has a temperature of 39{degrees}C. A physical examination is remarkable for diffuse pharyngeal erythema with moderately enlarged tonsils and the presence of several enlarged, tender anterior and posterior cervical lymph nodes. How should this case be managed? (Source: New England Journal of Medicine)

CME: Infectious Mononucleosis

New England Journal of Medicine — Tue, 25 May 2010 23:00:00 +0100

(No abstract is available for this citation) (Source: New England Journal of Medicine)

Interaction of Epstein-Barr virus (EBV) with human B-lymphocytes.

Biochemical and Biophysical Research communications — Thu, 20 May 2010 23:00:00 +0100

We describe the mechanisms of some of the functional interactions between EBV encoded and cellular proteins that determine the phenotype of latently infected B-cells. The growth promoting EBV encoded genes are not expressed in the virus carrying BL cells. Still, EBV seems to contribute to the etiology of this tumor by modifying events that influence cell survival and proliferation. We describe a possible growth promoting mechanism in the genesis of Burkitt lymphoma that depends on the presence of EBV. PMID: 20494113 [PubMed - in process] (Source: Biochemical and Biophysical Research communications)

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Interleukin-27 expression following infection with the murine gammaherpesvirus 68.

Cytokine — Tue, 18 May 2010 23:00:00 +0100

Authors: Nelson DA, Tolbert MD, Clemens MG, Bost KL IL-27 is a heterodimeric cytokine composed of p28 and Epstein Barr virus induced gene 3 (Ebi3) protein subunits. In the present study, we questioned whether murine gammaherpesvirus 68 (HV-68) could induce expression of Ebi3, p28, and IL-27 in this mouse model of an EBV-like infection. Cultured macrophages and dendritic cells exposed to HV-68 upregulated p28 mRNA expression and increased secretion of the p28 and IL-27 (p28+Ebi3) proteins. B220(+) and CD11b(+) cells also upregulated p28 mRNA expression following in vivo infection with this virus. Surprisingly, no significant increases in p28 or IL-27 protein production were observed in vivo during the acute or mononucleosis phases of the disease. The possibility that HV-68-induced upreg...

Cutaneous Lymphoproliferative Disorder Complicating Infectious Mononucleosis in an Immunosuppressed Patient

Pediatric Dermatology — Sun, 16 May 2010 23:00:00 +0100

We report a solitary cutaneous lesion of an immunosuppression-related lymphoproliferative disorder (IR-LPD) occurring as a complication of infectious mononucleosis, and review the pathogenesis and reported cases of Epstein-Barr virus-related immunosuppression-related lymphoproliferative disorder arising in the setting of inflammatory bowel disease. It is important for dermatologists and dermatopathologists to be aware of the occurrence of IR-LPD in patients being treated for inflammatory conditions, including inflammatory bowel disease. Given the role of primary infection with Epstein-Barr virus in the development of IR-LPD, consideration may be given to assessing Epstein-Barr virus status prior to initiating immunosuppressive therapy in young patients. (Source: Pediatric Dermatology)

The trouble with ME

Guardian Unlimited Science — Thu, 13 May 2010 20:00:02 +0100

We mark ME awareness week with a report on the latest research into chronic fatigue syndrome – and the controversy that surrounds the subject• Living with chronic fatigue syndrome Kay Gilderdale helped her 31-year-old daughter to kill herself over the course of one long December night, crushing up sleeping pills and antidepressants when the morphine overdose she gave her to inject did not immediately work. It's almost incredible to think that a mother and daughter could be driven to such hellish extremes by a disease that is not fatal. Lynn Gilderdale had ME.But Lynn's extraordinary and distressing story takes few people acquainted with ME (myalgic encephalopathy), also known as CFS (chronic fatigue syndrome), by surprise. If nothing else, it illustrates the despair that ME/CFS en...

Characterization of variants in the promoter of BZLF1 gene of EBV in nonmalignant EBV-associated diseases in Chinese children

Virology Journal — Sun, 09 May 2010 23:00:00 +0100

Conclusions: Type 1 EBV and BZLF1 Zp-P of EBV were the predominant genotypes in nonmalignant EBV associated diseases in Chinese children and Zp-V3 variant may correlates with the developing of severe EBV infection diseases, such as CAEBV and EBV-HLH. (Source: Virology Journal)

Exercise Tolerance Testing in a Prospective Cohort of Adolescents with Chronic Fatigue Syndrome and Recovered Controls following Infectious Mononucleosis

The Journal of Pediatrics — Thu, 06 May 2010 23:00:00 +0100

Conclusions: Adolescents with CFS 6 months after IM have a lower degree of fitness and efficiency of exercise than recovered adolescents. Whether these abnormal exercise findings are a cause or effect of CFS is unknown. IM can lead to both fatigue and measurable changes in exercise testing in a subset of adolescents. (Source: The Journal of Pediatrics)

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Clinical Significance of Cloned Expansion and CD5 Down‐Regulation in Epstein‐Barr Virus (EBV)–Infected CD8+ T Lymphocytes in EBV‐Associated Hemophagocytic Lymphohistiocytosis

The Journal of Infectious Diseases Latest Issue — Thu, 06 May 2010 07:09:55 +0100

The Journal of Infectious Diseases, Volume 0, Issue 0, Page 000, Latest Articles. Epstein‐Barr virus (EBV) is the pathogen that most commonly triggers infection‐associated hemophagocytic lymphohistiocytosis (HLH) and ectopically infects CD8+ T cells in EBV‐associated HLH (EBV‐HLH). We recently described an EBV‐HLH patient who had a clonally expanded population of EBV‐infected CD8+ T cells with CD5 down‐regulation. To determine whether this finding could serve as a useful marker for EBV‐HLH, we investigated 5 additional patients. We found a significant increase in the subpopulation of CD8+ T cells with CD5 down‐regulation and bright human leukocyte antigen (HLA)–DR expression in all patients with EBV‐HLH but not in patients with infectious mononucleosis or in con...

Peripheral blood alterations in a patient with infectious mononucleosis

British Journal of Haematology — Tue, 04 May 2010 23:00:00 +0100

(Source: British Journal of Haematology)

Infectious mononucleosis in Turkish children.

The Turkish Journal of Pediatrics — Fri, 30 Apr 2010 23:00:00 +0100

Authors: Cengiz AB, Cultu-KantaroÄlu O, SeÃ§meer G, Ceyhan M, Kara A, GÃ¼rgey A The aim of this study was to analyze the demographic, clinical and laboratory characteristics and prognoses of children diagnosed with infectious mononucleosis (IM). The demographic features, referral complaints, clinical and laboratory findings, follow-up, and prognoses of 44 patients diagnosed with IM between January 2000 and June 2006 at the Infectious Diseases Department of Hacettepe University Ihsan DoÄramaci Children's Hospital were analyzed retrospectively. The children suspected of IM based on clinical findings and whose diagnoses were proven by serological tests were enrolled in the study. In addition, the patients were divided into four groups -namely, age 0-4, age 5-8, age 9-12 and age ...

Epstein-Barr virus can infect rabbits by the intranasal or peroral route: An animal model for natural primary EBV infection in humans

Journal of Medical Virology — Sun, 18 Apr 2010 23:00:00 +0100

In this study, a natural EBV-infection rabbit model by intranasal or peroral inoculation is described. Ten male rabbits were examined for EBV-DNA or mRNA expression and anti-EBV antibodies in blood. Four of 10 rabbits showed the evidence of EBV infection; detection of EBV-DNA or EBV-related genes mRNA in peripheral blood mononuclear cells, increased EBV antibodies in the plasma, and the presence of lymphocytes expressing EBER1 and EBV-related gene proteins in the lymphoid tissues of a rabbit. Three of four infected rabbits were detected transiently EBV-DNA and/or mRNA of EBV-related genes such as EBNA1, EBNA2, BZLF1, and EA in blood, while in one of four, EBV-DNA and/or mRNA were detected for more than 200 days after viral inoculation. The level of EA-IgG increased and its level was mainta...

EBV viral load detection in clinical virology

Journal of Clinical Virology — Wed, 14 Apr 2010 23:00:00 +0100

EBV infects virtually the entire human population and persists throughout the lifetime of its host. In lower socioeconomic strata and developing nations, infection is almost universally acquired in early childhood, and is usually subclinical. In industrialized nations, particularly among the upper socioeconomic strata, subjects are often infected in adolescence and early adult life when 23–74% of infections result in the infectious mononucleosis (IM) syndrome, an immunopathological disease where symptoms are the result of an exaggerated T cell response to a self-limited lymphoproliferative process. Unusual and severe complications in the form of hemophagocytic syndromes and chronic EBV infections occur rarely. Viral reactivation can occur in seropositive subjects. This does not cause sym...

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Pediatric Health Associates — Wed, 14 Apr 2010 18:40:00 +0100

From the desk of Sarah Valek, R.N.Get a jump on the upcoming school physical season by scheduling your child's appointment now! This will avoid the summer rush and ensure that your child is ready for the fall.School physicals are required when your child is entering kindergarten, 5th grade and high school. Sports physicals are required for certain activities before your child can participate. And if your child is going to camp this summer and needs a physical, why not get it done now so they are ready when the time comes.Children should be seen at least annually for a well check so their overall health is assessed. Just taking them in when they have an ear ache does not address everything else.Some parents may be tempted to go to the local pharmacy's walk in clinic for convenience. They ma...

Smoking May Boost Multiple Sclerosis Risk in Some

MedlinePlus Health News — Wed, 07 Apr 2010 20:00:00 +0100

Those with high levels of Epstein-Barr antibodies double their chances if they smoke, study found Source: HealthDay Related MedlinePlus Pages: Infectious Mononucleosis, Multiple Sclerosis, Smoking (Source: MedlinePlus Health News)

HLA-A alleles and infectious mononucleosis suggest a critical role for cytotoxic T-cell response in EBV-related Hodgkin lymphoma [Genetics]

Proceedings of the National Academy of Sciences — Tue, 06 Apr 2010 16:47:36 +0100

A proportion of classical Hodgkin lymphoma (HL) is believed to be causally related to infection with the ubiquitous lymphotropic EBV.... (Source: Proceedings of the National Academy of Sciences)

Epstein–Barr Virus Infection and Multiple Sclerosis: A Review

Journal of NeuroImmune Pharmacology — Mon, 05 Apr 2010 21:36:14 +0100

Abstract Epstein–Barr virus (EBV) infection results in a life-long persistence of the virus in the host’s B-lymphocytes and has been associated with numerous cancers including Burkitt’s lymphoma, Hodgkin lymphoma, and nasopharyngeal carcinoma. There is considerable evidence that EBV infection is a strong risk factor for the development of multiple sclerosis. Early age at primary EBV infection is typically asymptomatic, but primary infection during adolescence or adulthood often manifests as infectious mononucleosis, which has been associated with a two- to threefold increased risk of MS. Most importantly, MS risk is extremely low in individuals who are EBV negative, but it increases several folds following EBV infection. Additional evidence supporting a role for EBV ...

Prevention and Treatment of Infectious Complications After Solid Organ Transplantation in Children

Pediatric Clinics of North America — Wed, 31 Mar 2010 23:00:00 +0100

Effective prevention, diagnosis, and treatment of infectious diseases after transplantation are key factors contributing to the success of organ transplantation. Most transplant patients experience different kinds of infections during the first year after transplantation. Children are at particular risk of developing some types of infections by virtue of lack of immunity although they may be at risk for other types due the effect of immunosuppressive regimens necessary to prevent rejection. Direct consequences of infections result in syndromes such as mononucleosis, pneumonia, gastroenteritis, hepatitis, among other entities. Indirect consequences are mediated through cytokines, chemokines, and growth factors elaborated by the transplant recipient in response to microbial replication and i...

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Adult-onset Still's disease and cytomegalovirus infection.

Acta Reumatologica Portuguesa — Wed, 31 Mar 2010 23:00:00 +0100

We present a case of a previously asymptomatic 34-year-old man that presented to the emergency department with two weeks of fever, arthralgia of the wrists and knees and sore throat. He was diagnosed with cytomegalovirus (CMV) mononucleosis. The patient remained symptomatic in the 5 following months. After an extensive workup to exclude other clinical conditions, a liver biopsy was performed and CMV hepatitis was diagnosed. He started valganciclovir therapy. Approximately one year after the initial complaints, the patient remained ill and presented clinical criteria compatible with Adult Onset Still's Disease. The patient had a marked improvement after institution of prednisolone, an effect that has been sustained during the following months. PMID: 20711100 [PubMed - as supplied by pub...

Atypical infectious mononucleosis with leukopenia

Acta Paediatrica — Mon, 08 Mar 2010 00:00:00 +0100

(Source: Acta Paediatrica)

Serological Profile of Pretransplantation Liver Patients

Transplantation Proceedings — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Our analysis showed the importance of serological investigations and diagnostic examinations before the transplantation procedure, seeking to minimize possible reactivation of the disease after the use of immunosuppression drugs, particularly in the first 6 months after transplantation, or even to avoid a primary infection. (Source: Transplantation Proceedings)

Pathogenesis of extrapulmonary manifestations of Mycoplasma pneumoniae infection with special reference to pneumonia

Journal of Infection and Chemotherapy — Fri, 26 Feb 2010 06:45:37 +0100

Abstract Although pneumonia has been a hallmark of Mycoplasma pneumoniae infection, it has been revealed that this infection can cause a number of extrapulmonary manifestations in the absence of pneumonia. While the host immune response has been implicated in the pathomechanism of pneumonia, the pathomechanisms of extrapulmonary manifestations remain largely unknown. It is proposed in this review that extrapulmonary manifestations due to M. pneumoniae infection can be classified into three categories; the first is a direct type in which inflammatory cytokines locally induced by lipoproteins contained in the bacterial cell membrane must play a role, the second is an indirect type in which immune modulation such as autoimmunity through cross-reaction between the bacterial...

Postsplenectomy Cytomegalovirus Mononucleosis is a Distinct Clinicopathologic Syndrome.

The American Journal of the Medical Sciences — Fri, 26 Feb 2010 00:00:00 +0100

We describe a case of severe CMV mononucleosis that was acquired naturally decades after splenectomy. Together with the 2 similar cases that we reported recently, these cases all presented as initial diagnostic challenge because of a remote history of splenectomy, a prolonged febrile illness ( approximately 4 weeks), marked lymphocytosis (peak 27.9 x 10/L), and undetectable or weakened anti-CMV IgM antibody response. The diagnosis was eventually established through detection of circulating CMV antigen or DNA and a year or longer follow-up with serial determination of IgM and IgG antibodies. Two similar cases were also identified in the literature and reviewed. Although the impaired IgM response may confuse the diagnosis, it correlates well with recent studies showing that human blood IgM m...

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CKS topic review: Glandular fever

NeLM - Guidelines — Tue, 23 Feb 2010 00:00:00 +0100

Source: Clinical Knowledge Summaries (CKS) Area: Evidence > Guidelines This CKS topic covers the diagnosis and management of glandular fever (infectious mononucleosis) in primary care. (Source: NeLM - Guidelines)

Azathioprine: EBV infectious mononucleosis complicated by various toxicities: case report

Reactions — Mon, 22 Feb 2010 14:16:47 +0100

(Source: Reactions)

Infectious mononucleosis lymphoadenitis showing histologic findings indistinguishable from toxoplasma lymphadenitis. A report of three cases.

Pathology, Research and Practice — Mon, 22 Feb 2010 00:00:00 +0100

We report here three cases of IM lymphadenitis with histologic findings indistinguishable from those of toxoplasmic lymphadenitis. The histologic findings of the three cases presented here showed a histologic triad of toxoplasmic lymphadenitis, including (i) numerous lymphoid follicles with hyperplastic germinal centers; (ii) small clusters or single epithelioid histiocytes; and (iii) multiple foci of monocytoid B-cells. Moreover, all three lesions contained isolated or small clusters of epithelioid histiocytes within the hyperplastic germinal centers and the periphery of lymphoid follicles, which are the most specific histologic findings of toxoplasmic lymphadenitis. However, serologic findings confirmed EBV infection in all three cases. On in situ hybridization, numerous Epstein-Barr vir...

Fever of Unknown Origin: A Diagnostic Approach to This Vexing Problem

Clinical Pediatrics — Wed, 17 Feb 2010 07:22:38 +0100

Fever is a common complaint leading families to seek medical attention. Its routine management is the bread and butter of pediatric practice. When fever is seen as prolonged beyond the expected time course (eg, 10 days for a presumed viral respiratory tract infection or 3 weeks for mononucleosis), concern for fever of unknown origin (FUO) may ensue. This diagnosis is among the most challenging for health care providers to approach and often involves referral to subspecialists. Generally, the pace of the evaluation should be guided by the severity of the disease, rather than the anxiety of the family or of the health care providers. It is useful to recognize that uncommon manifestations of common diseases are more likely than are rare diseases. Furthermore, clues to the diagnosis are freque...

Hsp90 inhibitors block outgrowth of EBV-infected malignant cells in vitro and in vivo through an EBNA1-dependent mechanism [Microbiology]

Proceedings of the National Academy of Sciences — Tue, 16 Feb 2010 18:56:49 +0100

EBV causes infectious mononucleosis and is associated with certain malignancies. EBV nuclear antigen 1 (EBNA1) mediates EBV genome replication, partition,... (Source: Proceedings of the National Academy of Sciences)

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Concordance rate of alopecia areata in identical twins supports both genetic and environmental factors

Journal of the American Academy of Dermatology — Tue, 16 Feb 2010 14:09:36 +0100

To the Editor: We previously reported that alopecia areata (AA), an autoimmune disease targeting the hair follicle causing hair loss, had a 55% concordance rate in monozygotic twins, suggesting both genetic and environmental triggers. Recently, we also reported a possible association between Epstein–Barr virus (EBV)-related mononucleosis and onset of AA in 12 young individuals. To further study the role of genes versus environment in the pathogenesis of AA, we examined concordance rates for AA and exposure to EBV by IgG serology in a new cohort of twins from the National Alopecia Areata Registry. (Source: Journal of the American Academy of Dermatology)

Fulminant Infectious Mononucleosis and Recurrent Epstein‐Barr Virus Reactivation in an Adolescent

Clinical Infectious Diseases Latest Issue — Tue, 16 Feb 2010 08:05:34 +0100

We describe a unique case of fulminant infectious mononucleosis and recurrent Epstein‐Barr virus reactivation presenting in an adolescent. Detailed assays of Epstein‐Barr virus–specific T cell immunity revealed defects in the patient's T cell receptor signalling pathway characterized by a lack of interleukin‐2 and CD25 expression, which may have contributed to her clinical course. Allogeneic stem cell transplantation reversed the clinical and laboratory phenotype. (Source: Clinical Infectious Diseases Latest Issue)

Infectious Mononucleosis in University Students in the United Kingdom: Evaluation of the Clinical Features and Consequences of the Disease

Clinical Infectious Diseases Latest Issue — Tue, 02 Feb 2010 16:28:44 +0100

Conclusions. IM results in substantial morbidity among university students, reported as more profound in females, and affecting academic studies, physical exercise, and social activities. Immunization to prevent IM and strategies to reduce post‐IM disability would be beneficial in this population. (Source: Clinical Infectious Diseases Latest Issue)

Antiphospholipid Syndrome and Acute HIV Infection.

Emerging Infectious Diseases — Mon, 01 Feb 2010 00:00:00 +0100

Authors: Diaz JS, Octavio JG, Fernandez-Guerrero ML To the Editor: Patients with acute HIV infection frequently experience a syndrome characterized by fever, sore throat, lymphadenopathy, maculopapular rash, and lymphomonocytosis, which mimics acute infectious mononucleosis, 3-6 weeks after primary infection (1). Aseptic meningitis, encephalitis, and peripheral neuropathy are the most commonly observed features. In contrast, antiphospholipid syndrome complicated with pulmonary emboli is not commonly associated with acute retroviral syndrome. The following case should prompt clinicians to consider an expanded clinical scope of initial signs and symptoms for acute HIV infection. PMID: 20113589 [PubMed - in process] (Source: Emerging Infectious Diseases)

Illustrated Approach to Imaging and Staging of Nodal Disease in the Neck

Current Problems in Diagnostic Radiology — Thu, 28 Jan 2010 15:44:56 +0100

This article provides a review of the anatomic classification and staging of nodal disease in the neck through the use of tables, illustrations, and sample imaging cases. The article reinforces knowledge of nodal disease in the neck while reviewing imaging examples of common and uncommon disease entities in this region. We review nodal disease in the neck using American Joint Committee on Cancer staging criteria. We illustrate anatomy of the nodal levels of the neck with accompanying examples of selected cases. These are presented in an integrated manner, highlighting items of importance to radiologists. The accompanying images and clinical scenarios aid recognition with an emphasis on differential diagnosis. Case examples include a broad range of pathologically and clinically proven disea...

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Health Tip: Recovering From Mononucleosis

The Doctors Lounge - Infections — Tue, 19 Jan 2010 15:00:00 +0100

Suggestions to help relieve symptoms (Source: The Doctors Lounge - Infections)

Health Tip: Recovering from Mononucleosis

MedlinePlus Health News — Tue, 19 Jan 2010 14:00:00 +0100

Suggestions to help relieve symptoms Source: HealthDay Related MedlinePlus Topic: Infectious Mononucleosis (Source: MedlinePlus Health News)

High-dose dexamethasone therapy for severe thrombocytopenia and neutropenia induced by EBV infectious mononucleosis.

International Journal of Hematology — Sat, 16 Jan 2010 00:00:00 +0100

Authors: Kagoya Y, Hangaishi A, Takahashi T, Imai Y, Kurokawa M PMID: 20082159 [PubMed - as supplied by publisher] (Source: International Journal of Hematology)

Deficiency of the proapoptotic SAP function in X-linked lymphoproliferative disease aggravates Epstein-Barr virus (EBV) induced mononucleosis and promotes lymphoma development.

Immunology Letters — Thu, 14 Jan 2010 00:00:00 +0100

Authors: Nagy N, Klein E The lack of functional SAP protein, a consequence of mutation or deletion of the SH2D1A gene is the cause of X-linked lymphoproliferative disease (XLP). We and others have shown that SAP can be involved in apoptosis. Activation induced apoptosis plays a pivotal role in the termination of the lymphocyte proliferation in infectious mononucleosis IM. This mechanism is inefficient in the XLP patients. Primary EBV infection of boys with XLP leads therefore to fulminant, often even fatal disease. In addition, the condition predisposes to considerably elevated incidence of lymphomas. PMID: 20080127 [PubMed - as supplied by publisher] (Source: Immunology Letters)