MedWorm: Glandular Fever (infectious mononucleosis)

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...

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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...

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...

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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)

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)

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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...

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)

Profound EBV-driven lymphoid hyperplasia of rectal tonsil mimicking high grade lymphoma

Diagnostic Histopathology — Mon, 11 Jan 2010 00:00:00 +0100

We present an unusual case of a localized EBV-driven lymphoproliferation within the rectum showing histological features suggestive of malignant lymphoma. The rectal lymphoid tissue (rectal tonsil) contained an infiltrate composed of large, transformed lymphoid cells with prominent nucleoli and immunoblastic morphology. These cells showed an abnormal phenotype, CD30 expression and EBER positivity. The patient was otherwise well, with no evidence of disease at others sites, and PCR studies found no evidence of clonality. EBV related lymphoid proliferation with transformed cells is well recognized in the palatine tonsil in association with infectious mononucleosis, but similar appearances are not described in the rectum. (Source: Diagnostic Histopathology)

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Effects of infectious mononucleosis and HLA-DRB1*15 in multiple sclerosis

Multiple Sclerosis — Tue, 05 Jan 2010 16:56:21 +0100

(Source: Multiple Sclerosis)

Case report Acute drug eruption as a result of therapy with the new generation anticonvulsant drug lamotrigine – case report

Articles of Advances in Dermatology and Allergology - TERMEDIA publishing house — Mon, 04 Jan 2010 12:04:24 +0100

We describe an 18-year old woman with generalized eruption which started 14 days after initiation of the new anticonvulsant drug lamotrigine. The patient was observed for mononucleosis, virus throat infection and angina before hospitalization. She was admitted to the Dermatology Clinic in Kraków in general good condition on the 4th day of steroid therapy with dexamethasone in a dose of 24 mg per day. On physical examination generalized erythema and inflammatory skin lesions were seen with colliquative tendency and positive Nikolsky sign. Laboratory tests (morphology, coagulation parameters, liver and kidney testes) were correct. Due to multi-aetiological and still unknown mechanisms of drug eruption, recommended therapy is inconsistent. We decided to stop lamotrigine therapy and to start ...

High incidence of Epstein Barr virus infection in childhood acute lymphocytic lukemia: A preliminary study.

Indian Journal of Pathology and Microbiology — Fri, 01 Jan 2010 00:00:00 +0100

Conclusion: These studies indicate that a significant number of patients with ALL show evidence of active EBV replication. PMID: 20090225 [PubMed - in process] (Source: Indian Journal of Pathology and Microbiology)

[Severe drug hypersensitivity reaction (DRESS syndrome) to doxycycline.]

Annales de Dermatologie et de Cenereologie — Fri, 01 Jan 2010 00:00:00 +0100

CONCLUSION: This patient is the third case of DRESS to doxycycline described in the literature. The originality of this case lies in the allergological investigation using patch-tests and HLA determination. PMID: 20110067 [PubMed - as supplied by publisher] (Source: Annales de Dermatologie et de Cenereologie)

Infectious mononucleosis hepatitis in young adults: two case reports.

The Korean Journal of Internal Medicine — Tue, 01 Dec 2009 00:00:00 +0100

Authors: Kang MJ, Kim TH, Shim KN, Jung SA, Cho MS, Yoo K, Chung KW Infectious mononucleosis due to Epstein-Barr virus (EBV) infection sometimes causes acute hepatitis, which is usually self-limiting with mildly elevated transaminases, but rarely with jaundice. Primary EBV infection in children is usually asymptomatic, but in a small number of healthy individuals, typically young adults, EBV infection results in a clinical syndrome of infectious mononucleosis with hepatitis, with typical symptoms of fever, pharyngitis, lymphadenopathy, and hepatosplenomegaly. EBV is rather uncommonly confirmed as an etiologic agent of acute hepatitis in adults. Here, we report two cases: the first case with acute hepatitis secondary to infectious mononucleosis and a second case, with acute hepatitis se...

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Herpesviruses

Medicine — Mon, 30 Nov 2009 16:03:40 +0100

Abstract: Herpesviruses are highly successful viruses because they transmit to many individuals in all populations, often without causing obvious symptoms. However, they are responsible for significant diseases, including herpes simplex encephalitis, genital herpes, chickenpox, infectious mononucleosis, cytomegalic inclusion disease, exanthem subitum and Kaposi's sarcoma. They also cause severe opportunistic disease in patients with T-cell immunodeficiency. Antiviral drugs have greatly reduced the burden of disease caused by herpesviruses. Aciclovir and penciclovir (with their pro-drugs valaciclovir and famciclovir, respectively) are safe in clinical practice. Ganciclovir (and its pro-drug valganciclovir) and foscarnet have significant toxic effects but are clearly indicated for either pre...

Hypothesis: Could Epstein-Barr virus play a role in the development of gastroschisis?

Birth Defects Research Part A: Clinical and Molecular Teratology — Fri, 20 Nov 2009 00:00:00 +0100

The strong inverse association between maternal age and risk of gastroschisis in offspring has spurred many investigators to hypothesize that behaviors among younger females are the cause. Examples include cigarette smoking, illicit drugs, genitourinary infections, and sexually transmitted diseases, each of which has been reported to be associated with gastroschisis. Although these exposures are more common in young women, recent studies have shown that cigarette smoking, genitourinary infections, and sexually transmitted diseases are most strongly associated with gastroschisis in older women. There is both anecdotal and published evidence showing that gastroschisis sometimes (but not always) occurs in clusters, raising the possibility that an infectious agent might be involved in its path...

Multiple sclerosis: Geoepidemiology, Genetics and the environment.

Autoimmunity Reviews — Thu, 19 Nov 2009 00:00:00 +0100

Authors: Milo R, Kahana E Multiple sclerosis (MS) is a chronic immune-mediated demylinating disease of the central nervous system characterized by relapses and remissions. The risk of acquiring this complex disease is associated with exposure to environmental factors in genetically susceptible individuals. The epidemiology of MS has been extensively studied. We review the geographic epidemiology of the disease, the influence of immigration, age at immigration, clustering and epidemics. Various presumptive risk factors are discussed such as ultra-violet radiation, vitamin D, Epstein-Barr virus and infectious mononucleosis, other infectious agents and non-infectious factors. Two different hypotheses, the hygiene hypothesis and the prevalence hypothesis, were proposed to explain these env...

Mononucleosis and Epstein-Barr: What's the connection?

MayoClinic.com - Ask a Specialist — Fri, 13 Nov 2009 02:45:03 +0100

Epstein-Barr virus sometimes causes mononucleosis, but most Epstein-Barr infections are less severe. Sponsored by:Chemotherapy.com - http://www.chemotherapy.com (Source: MayoClinic.com - Ask a Specialist)

Mononucleosis and Epstein-Barr: What's the connection?

MayoClinic.com Full Feed — Thu, 12 Nov 2009 06:00:00 +0100

Epstein-Barr virus sometimes causes mononucleosis, but most Epstein-Barr infections are less severe. Sponsored by:Chemotherapy.com - http://www.chemotherapy.com (Source: MayoClinic.com Full Feed)

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Valacyclovir Pharmacokinetics and Exploratory Pharmacodynamics in Young Adults With Epstein-Barr Virus Infectious Mononucleosis.

The Journal of Clinical Pharmacology — Fri, 06 Nov 2009 00:00:00 +0100

The objectives of this study are to characterize the pharmacokinetics and explore the pharmacodynamics of acyclovir in plasma and oral washings of 8 subjects receiving 7 days of valacyclovir 1500 mg twice daily for EBV infectious mononucleosis. Virologic and clinical responses are assessed over 12 days. Acyclovir is measured by liquid chromatography/ultraviolet detection. EBV DNA is quantitated by TaqMan polymerase chain reaction. NONMEM VI and linear regression are used for data analysis. Acyclovir profiles in plasma and oral washings are consistent with a 1-compartment model. Final model estimates of clearance, volume of distribution, and fraction of acyclovir in oral wash supernatant are 49.9 L/h, 74.1 L, and 1.14%, respectively. The quantity of EBV DNA in oral washings and blood, and t...

Genitourinary manifestations of Epstein-Barr virus infections

Current Infectious Disease Reports — Thu, 05 Nov 2009 18:31:00 +0100

This article reviews the available literature and data regarding EBV in the female genital tract and discusses areas of consensus and controversy. The primary manifestation of EBV seems to be vulvar ulcers, which are underrecognized. Diagnosis relies on appropriate serologic testing. Management includes local care and may require pain and corticosteroid medications. Although EBV is present elsewhere in the female genital tract, its pathogenic role in the cervix, uterus, fallopian tubes, and ovaries is poorly understood. Content Type Journal ArticleDOI 10.1007/s11908-009-0065-8Authors Randi LeighPaul Nyirjesy, Drexel University College of Medicine Department of Obstetrics and Gynecology 245 North 15th Street, New College Building, 16th Floor Philadelphia PA 19102 USA Journal...

False positive immunoglobulin m antibody to cytomegalovirus in child with infectious mononucleosis caused by epstein-barr virus infection.

Yonsei Medical Journal — Sat, 31 Oct 2009 00:00:00 +0100

Authors: Park JM, Shin JI, Lee JS, Jang YH, Kim SH, Lee KH, Lee CH A 16-month-old boy was admitted because of cough that had lasted for 10 days. The patient showed severe hepatomegaly incidentally, and dual positivity of Immunoglobulin (Ig) M to Epstein-Barr virus (EBV) viral capsid antigen (VCA) and cytomegalovirus (CMV). On the basis of seroconversion to Epstein-Barr nuclear antigen (EBNA) Ig G positivity and reduced CMV Ig M titer with persistently negative CMV Ig G, a definite diagnosis of EBV-induced infectious mononucleosis was established 1 year 2 month later. PMID: 19881978 [PubMed - in process] (Source: Yonsei Medical Journal)

Case 34-2009 -- A 20-Year-Old Man with Sore Throat, Fever, and Rash

New England Journal of Medicine — Wed, 28 Oct 2009 00:00:00 +0100

A 20-year-old man was admitted to this hospital because of sore throat, fever, and a diffuse rash for 1 week. Testing for streptococcal pharyngitis and mononucleosis was negative. Amoxicillin and clavulanate were prescribed, and the next day, a red, itchy rash developed on the medial surface of his right arm; the lesions became raised, enlarged, and painful and spread from his arms to his legs, back, hands, feet, and perioral area, without mucosal involvement. Examination disclosed a diffuse eruption of tender violaceous-pink papulovesicles, which progressed to hemorrhagic crusting. A diagnostic procedure was performed. (Source: New England Journal of Medicine)

Got Bad Breath? Try Chlorophyll for Halitosis

NaturalNews.com — Fri, 16 Oct 2009 07:00:00 +0100

(NaturalNews) Forget about breath mints. You can never take enough to cover halitosis if your breath really smells bad. The only real way to get rid of bad breath is to solve the problem internally.Fortunately, there's an easy way to do that: Chlorophyll. It's Mother Nature's amazing green cleaning machine, and the more you take, the cleaner you get.Here, we bring you a collection of supporting quotes about chlorophyll and halitosis (bad breath) from some of the best-known natural health authors in the industry. You'll learn not only why chlorophyll works so well, but also the best sources for getting some.Of course, if you don't have time to read this, there's always mouthwash...Chlorophyll eliminates bad breathTaken from the green pigment in plants, chlorophyll is very similar in chemica...

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What Is Glandular Fever? What Causes Glandular Fever? What Is Infectious Mononucleosis?

Health News from Medical News Today — Wed, 14 Oct 2009 15:00:00 +0100

Glandular fever is a type of viral infection. It is also known as infectious mononucleosis. It can cause fever, sore throat, fatigue, swollen lymph nodes and glands. It is caused by the Epstein-Barr virus (EBV). It is one of the most common viruses that can affect humans. Most EBV infections occur during early childhood. They usually produce few or no symptoms. (Source: Health News from Medical News Today)

Antiviral drug found to cut the severity of mono

OrlandoSentinel: Medical Research — Sat, 03 Oct 2009 23:00:00 +0100

Mononucleosis, the curse of high school and college students, doesn't have to bring social and academic lives to a screeching halt, researchers say. Instead, the disease can be treated to shorten the duration of the illness and reduce the chance of... (Source: OrlandoSentinel: Medical Research)

Clinically controlled study on children’s infectious mononucleosis treated by Chinese medicine

Chinese Journal of Integrative Medicine — Sat, 03 Oct 2009 06:27:36 +0100

Conclusion Using Chinese herbs for clearing heat, removing toxin, activating blood circulation, and dissolving stasis is effective and safe for the treatment of CIM. It can effectively improve the clinical symptoms and shows a certain effect on immune regulation. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11655-009-0347-xAuthors Yuan Yao, Beijing Children’s Hospital Affiliated to Capital Medical University Beijing 100045 ChinaHong-mei Duan, Beijing University of Chinese Medicine School of Nursing Beijing 100102 ChinaHui-min Yan, Beijing Children’s Hospital Affiliated to Capital Medical University Beijing 100045 ChinaXiao-fang Zhen, Beijing Children’s Hospital Affiliated to Capital Medical University Beijing 100045 ChinaYu-chen Pan, Beijing ...

Antiviral drug found to reduce severity of mono

OrlandoSentinel: Medical Research — Thu, 01 Oct 2009 23:00:00 +0100

Mononucleosis

eMedicineHealth.com — Mon, 28 Sep 2009 07:00:00 +0100

(Source: eMedicineHealth.com)

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Epstein-Barr virus (EBV)-encoded small RNA is released from EBV-infected cells and activates signaling from toll-like receptor 3

The Journal of Experimental Medicine — Sun, 27 Sep 2009 23:00:00 +0100

Epstein-Barr virus–encoded small RNA (EBER) is nonpolyadenylated, noncoding RNA that forms stem-loop structure by intermolecular base-pairing, giving rise to double-stranded RNA (dsRNA)–like molecules, and exists abundantly in EBV-infected cells. Here, we report that EBER induces signaling from the Toll-like receptor 3 (TLR3), which is a sensor of viral double-stranded RNA (dsRNA) and induces type I IFN and proinflammatory cytokines. A substantial amount of EBER, which was sufficient to induce signaling from TLR3, was released from EBV-infected cells, and the majority of the released EBER existed as a complex with a cellular EBER-binding protein La, suggesting that EBER was released from the cells by active secretion of La. Sera from patients with infectious mononucleosis (IM),...

Medical news: Study offers hope for mono treatment

OrlandoSentinel: Medical Research — Tue, 22 Sep 2009 06:23:00 +0100

Mononucleosis, the curse of high school and college students, does not have to bring social and academic lives to a screeching halt, researchers reported this week. Instead, the disease can be treated to shorten its duration and reduce the chance of... (Source: OrlandoSentinel: Medical Research)

Epstein-Barr virus BZLF1 gene promoter variants in pediatric patients with acute infectious mononucleosis: Its comparison with pediatric lymphomas

Journal of Medical Virology — Mon, 21 Sep 2009 23:00:00 +0100

Epstein-Barr virus genotypes can be distinguished by polymorphic variations in the genes encoding EBNA2, 3A, 3B, and 3C. The immediate early gene BZLF1 plays a key role in modulating the switch from latency to lytic replication and therefore enabling viral propagation. The aim of this study was to investigate and compare BZLF1 promoter sequence (Zp) variation in pediatric infectious mononucleosis (IM) and in pediatric EBV positive lymphoma biopsies. Zp was sequenced from peripheral blood mononuclear cells (PBMC) and throat swabs from 10 patients with IM at the time of diagnosis (D0) and during convalescence; and from 13 lymphoma biopsies. Zp - P and Zp - V3 variants were found in eight and one IM patients, as well as in five and six tumor biopsies, respectively. A correlation between viral...

Antiviral drug found to reduce severity of mono

Los Angeles Times - Science — Mon, 21 Sep 2009 07:00:00 +0100

The so-called kissing disease is commonly treated only with rest. But in a study, young people who received an antiviral medication early in the illness became less sick. Mononucleosis, the curse of high school and college students, doesn't have to bring social and academic lives to a screeching halt, researchers say. Instead, the disease can be treated to shorten the duration of the illness and reduce the chance of transmission. (Source: Los Angeles Times - Science)

Antiviral drug found to reduce severity of mono

L.A. Times - Health — Fri, 18 Sep 2009 23:43:31 +0100

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Study offers hope for mono treatment

OrlandoSentinel: Medical Research — Tue, 15 Sep 2009 23:00:00 +0100

Antiviral drug found to reduce severity of mono

Los Angeles Times - Science — Mon, 14 Sep 2009 20:33:00 +0100

The so-called kissing disease is commonly treated only with rest. But in a study, young people who received an antiviral medication early in the illness became less sick. Mononucleosis, the curse of high school and college students, doesn't have to bring social and academic lives to a screeching halt, researchers reported today. Instead, the disease can be treated to shorten the duration of the illness and reduce the chance of transmission. (Source: Los Angeles Times - Science)

Antiviral drug found to reduce severity of mono

OrlandoSentinel: Medical Research — Mon, 14 Sep 2009 12:33:00 +0100

Mononucleosis, the curse of high school and college students, doesn't have to bring social and academic lives to a screeching halt, researchers reported today. Instead, the disease can be treated to shorten the duration of the illness and reduce the... (Source: OrlandoSentinel: Medical Research)

Inflammatory bowel disease and lymphoproliferative disorders: the dust is starting to settle [Recent advances in clinical practice]

Gut — Fri, 11 Sep 2009 17:01:57 +0100

The risk of lymphoproliferative disorders (LDs) has become a major concern for clinicians managing patients with inflammatory bowel disease (IBD). Yet it is difficult to distinguish the possible responsibility of immunosuppressive therapy from the background risk due to the inflammatory disorder itself. LDs are clonal B or T cell proliferation showing considerable heterogeneity and the incidence has increased since the 1970s. The strongest and best-established risk factors for LDs are primary and acquired immunodeficiency (HIV, immunosuppressant), notably via defective immune surveillance of Epstein–Barr virus. In many auto-immune diseases (eg, Sjögren’s syndrome), inflammatory diseases (eg, rheumatoid arthritis) or chronic suppuration (chronic pyothorax), the risk of LD i...

The apoptosis modulating role of SAP (SLAM associated protein) contributes to the symptomatology of the X linked lymphoproliferative disease.

Cell Cycle — Fri, 11 Sep 2009 06:16:25 +0100

Authors: Nagy N, Matskova L, Hellman U, Klein G, Klein E Deletion or mutation of the SH2D1A gene located at Xq25 is responsible for the development of the X-linked lymphoproliferative disease, XLP. Primary infection of the affected individuals with EBV leads to fulminant and often fatal infectious mononucleosis, FIM. Moreover, they run a 200 fold elevated risk for lymphoma development. Due to the critical role of the immune response for the outcome of EBV infection and the detection of EBV genomes in several malignancies, XLP studies have been mainly focused on the immunological aspects. The involvement of SAP in the apoptotic machinery provides a further aspect in the complex syndrome of XLP. Functional impairment of SAP leads to defective apoptotic responses. Activation induced apopt...

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[Recent advances in clinical practice] Inflammatory bowel disease and lymphoproliferative disorders: the dust is starting to settle

Gut — Thu, 10 Sep 2009 23:00:00 +0100

[From tonsillitis to coxitis. A case report.]

Tidsskrift for den Norske Laegeforening — Wed, 09 Sep 2009 23:00:00 +0100

We present a 19-year-old woman with a throat infection, increased temperature, a positive mononucleosis monospot test and clinical signs of a lower respiratory tract infection. The diagnosis was thought to be mononucleosis complicated by bacterial pneumonia, but she was later found to have Fusobacterium necrophorum in blood cultures. She subsequently developed metastatic abscesses in her lungs and hip joint and was diagnosed with Lemierre's Syndrome. This case report highlights the importance of close links between clinicians and microbiologists in order to prevent morbidity and mortality in patients with an infectious disease. PMID: 19756057 [PubMed - in process] (Source: Tidsskrift for den Norske Laegeforening)

The Role of Valacyclovir on Epstein–Barr Virus Viral Loads in Pediatric Liver Transplantation Patients

Transplantation Proceedings — Mon, 31 Aug 2009 23:00:00 +0100

Conclusion: In this small, non–placebo-controlled study, valacyclovir treatment was not effective to decrease peripheral blood EBV viral loads. (Source: Transplantation Proceedings)

Posttransplant Lymphoproliferative Disease in Pediatric Liver Transplant Recipients

Transplantation Proceedings — Mon, 31 Aug 2009 23:00:00 +0100

Abstract: Posttransplant lymphoproliferative disease was first reported in 1968. Posttransplant lymphoproliferative disease encompasses a range of abnormalities from benign infectious mononucleosis-like illnesses to non-Hodgkin's lymphomas with nodal and extranodal site involvement. We evaluated five children who had posttransplant lymphoproliferative disease after liver transplantation. Since 2001, we have performed 118 liver transplantations in 115 children. Five children (4.6%), including three girls and two boys of overall mean age, 3.9 year, developed posttransplant lymphoproliferative diseases. The indications for liver transplant were hepatoblastoma in one recipient and cholestatic liver disease in the remaining four subjects. Posttransplant lymphoproliferative disease was diagnosed...

Infectious Mononucleosis

MedicineNet Kids Health General — Mon, 24 Aug 2009 07:00:00 +0100

Title: Infectious MononucleosisCategory: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 8/24/2009 (Source: MedicineNet Kids Health General)

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Clinical values of multiple Epstein-Barr virus (EBV) serological biomarkers detected by xMAP technology

BioMed Central — Sat, 22 Aug 2009 23:00:00 +0100

Conclusion: Combined EBV serological biomarkers could improve the diagnostic values for NPC. Diverse EBV serological spectrums presented in populations with different EBV-associated diseases, but NPC patients have the highesr EBV activity. (Source: BioMed Central)

A case of sulphasalazine-induced DRESS syndrome with delayed acute interstitial nephritis

Nephrology Dialysis Transplantation — Sun, 16 Aug 2009 23:00:00 +0100

We report the case of a 77-year-old female with sulphasalazine-induced DRESS syndrome who improved rapidly on corticosteroid treatment. After prednisone withdrawal, the patient developed renal failure that necessitated a session of haemodialysis. A kidney biopsy showed acute tubulointerstitial nephritis with an intense lymphocytic infiltrate and tubular necrosis. Kidney function normalized after a further 2 weeks of corticosteroid treatment. This is the first histologically proven case of acute tubulointerstitial nephritis in the setting of sulphasalazine-induced DRESS syndrome. (Source: Nephrology Dialysis Transplantation)

Glutamate dehydrogenase activity in lymphocytes of B-cell chronic lymphocytic leukaemia patients.

Clinical Biochemistry — Wed, 12 Aug 2009 23:00:00 +0100

Conclusions: The increased GLDH activity is specific for the PBMC of B-CLL patients. The GLUD1 but not the GLUD2 gene expression pattern is different between the PBMC of IM and B-CLL patients. PMID: 19683518 [PubMed - as supplied by publisher] (Source: Clinical Biochemistry)

Airway compromise in infectious mononucleosis: a case report

Cases Journal — Sun, 02 Aug 2009 23:00:00 +0100

A 25-year-old Caucasian man had difficulty swallowing and shortness of breath during an episode of infectious mononucleosis. His tonsils were "kissing" and erythematous but no superimposed infection with a streptococcal organism was identified. His symptoms improved rapidly upon administration of intravenous steroids. This case demonstrates a rare and short-term complication that is well described in young adults with infectious mononucleosis. Physicians should routinely counsel their patients with infectious mononucleosis to be aware of potentially life-threatening airway obstruction in addition to splenic rupture and meningitis. (Source: Cases Journal)

Sennetsu neorickettsiosis: a probable fish-borne cause of fever rediscovered in Laos.

The American Journal of Tropical Medicine and Hygiene — Thu, 30 Jul 2009 20:15:21 +0100

Authors: Newton PN, Rolain JM, Rasachak B, Mayxay M, Vathanatham K, Seng P, Phetsouvanh R, Thammavong T, Zahidi J, Suputtamongkol Y, Syhavong B, Raoult D Neorickettsia sennetsu has been described from Japan and Malaysia, causing a largely forgotten infectious mononucleosis-like disease. Because it is believed to be contracted from eating raw fish, frequently consumed in the Lao PDR, we looked for evidence of N. sennetsu among Lao patients and fish. A buffy coat from 1 of 91 patients with undifferentiated fever was positive by 16S rRNA amplification and sequencing and real-time polymerase chain reactions (PCR) targeting two N. sennetsu genes. Lao blood donors and patients with fever, hepatitis, or jaundice (N = 1,132) had a high prevalence (17%) of immunofluorescence assay IgG anti-N. s...

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Sunbeds dramatically raise cancer risk

Guardian Unlimited Science — Tue, 28 Jul 2009 23:05:20 +0100

This report was published in June and we are considering the recommendations in full." Government sources said action was "very likely".Kathy Banks, chief executive of the Sunbed Association, said it disputed IARC's reclassification of sunbeds as carcinogenic.She said: "There is no proven link between the responsible use of sunbeds and skin cancer. The relationship between UV exposure and an increased risk of developing skin cancer is only likely to arise where over-exposure – that is, burning – has taken place."This outcome would be the same whether burning takes place on a sunbed or on a beach or in a park or garden in natural sunlight. Over 80% of sunbed users are very knowledgeable about the risks associated with over-exposure to UV and the majority of sunbed users take 20 or less ...

Determination of marker pteridins and biopterin reduced forms, tetrahydrobiopterin and dihydrobiopterin, in human urine, using a post-column photoinduced fluorescence liquid chromatographic derivatization method.

Analytica Chimica Acta — Thu, 23 Jul 2009 03:06:08 +0100

Authors: Cañada-Cañada F, Espinosa-Mansilla A, Muñoz de la Peña A, Mancha de Llanos A A liquid chromatographic method for the simultaneous analysis of marker pteridins and biopterin reduced forms, in urine samples is proposed. A Zorbax Eclipse XDB-C18 column was used for the chromatographic separation, using a 98/2 (v/v), citrate buffer (pH 5.5)-acetonitrile mobile phase, in isocratic mode. A post-column photoderivatization was carried out with an on-line photoreactor, located between a diode array detector (DAD) and a fast scanning fluorescence detector (FSFD). Neopterin (NEO), biopterin (BIO), pterin (PT) and dihydrobiopterin (BH2) were determined by measuring native fluorescence, using the photoreactor in OFF-mode, and tetrahydrobiopterin (BH4) was determined by ...

Lymphocytic vasculitis involving the central nervous system occurs in patients with X-linked lymphoproliferative disease in the absence of Epstein-Barr virus infection

Pediatric Blood and Cancer — Sun, 19 Jul 2009 23:00:00 +0100

In this report, we describe two unrelated patients with fatal T-cell-mediated central nervous system vasculitis for whom repeated serologic and molecular testing for EBV was negative. In both patients, clonal T-cell populations were observed, but neither demonstrated evidence of lymphoma. Thus, loss of SAP function can lead to dysregulated immune responses characterized by the uncontrolled expansion and activation of T cells independent of EBV infection. Pediatr Blood Cancer. © 2009 Wiley-Liss, Inc. (Source: Pediatric Blood and Cancer)

"Mono" linked to chronic fatigue syndrome in teens

Reuters: Health — Wed, 15 Jul 2009 23:32:20 +0100

NEW YORK (Reuters Health) - Teens who develop "mono," otherwise known as infectious mononucleosis, may be at risk for chronic fatigue syndrome, according to a study in Pediatrics. (Source: Reuters: Health)

"Mono" Linked to Chronic Fatigue Syndrome in Teens

MedlinePlus Health News — Wed, 15 Jul 2009 22:32:20 +0100

Teens who develop "mono," otherwise known as infectious mononucleosis, may be at risk for chronic fatigue syndrome, according to a study in Pediatrics. Source: Reuters Health Related MedlinePlus Topics: Chronic Fatigue Syndrome, Infectious Mononucleosis, Teen Health (Source: MedlinePlus Health News)

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Infectious Mononucleosis May Increase Risk for Chronic Fatigue Syndrome in Teens

Medscape Medical News Headlines — Fri, 10 Jul 2009 13:12:41 +0100

Female sex and greater fatigue severity, but not reported steroid use during infectious mononucleosis, were linked to the development of chronic fatigue syndrome in teens. Medscape Medical News (Source: Medscape Medical News Headlines)

Acute lymphocytic crisis following herpes simplex type 1 virus hepatitis in a nonimmunocompromised man: a case report

Journal of Medical Case Reports — Tue, 30 Jun 2009 23:00:00 +0100

Conclusion: This case report shows that herpes simplex virus type 1 is a possible cause of an acute lymphocytic crisis similar to other well known infectious agents such as Epstein-Barr virus, cytomegalovirus, human immunodeficiency virus, human herpes virus type 6, adenovirus, toxoplasma and human T-cell lymphotropic virus. Furthermore, this case report expands the clinical spectrum of herpes simplex virus hepatitis, since it is reported in a nonimmunocompromised patient presenting with atypical acute lymphocytic syndrome. (Source: Journal of Medical Case Reports)

The uptake and use of the Monospot test in patients with tonsillitis.

Ir Med J — Tue, 30 Jun 2009 23:00:00 +0100

The objective of the study was to ascertain the uptake of the Monospot test in St. James's hospital in Dublin over the five years 2002-2006 and to determine the percentage of Monospot tests which had a positive result. Using the HIPE, Electronic Patient Record (EPR) and Patient Access System (PAS) databases in St. James's Hospital, a cohort of 593 patients with a diagnosis of tonsillitis or infectious mononucleosis was identified. Fourteen patients met the exclusion criteria as outlined below leaving a valid pool of 579 patients. It was ascertained whether each patient had a Monospot performed and if so, whether the result was positive or negative. In total, 249 (43.0%) of the included patients had a Monospot test. Of these, 197 (79.1%) were negative and 29 (11.6%) were positive. In 23 (9....

bioMérieux Launches VIDAS® EBV, a New Test for the Diagnosis of Infectious Mononucleosis

bioMerieux Press Releases — Mon, 29 Jun 2009 22:00:00 +0100

bioMérieux, a world leader in the field of in vitro diagnostics, today launched VIDAS® EBV for the detection of the Epstein-Barr virus (EBV). This virus causes 80% of cases of infectious mononucleosis, which is often known as “the kissing disease” because it is transmitted through saliva. (Source: bioMerieux Press Releases)

Chronic Fatigue Syndrome After Infectious Mononucleosis in Adolescents

PEDIATRICS — Sun, 28 Jun 2009 23:00:00 +0100

CONCLUSIONS: Infectious mononucleosis may be a risk factor for chronic fatigue syndrome in adolescents. Female gender and greater fatigue severity, but not reported steroid use during the acute illness, were associated with the development of chronic fatigue syndrome in adolescents. Additional research is needed to determine other predictors of persistent fatigue after infectious mononucleosis. (Source: PEDIATRICS)

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Increase of atypical lymphocytes expressing CD4+/CD45RO+ in an infectious mononucleosis-like syndrome associated with hepatitis A virus infection

Journal of Infection and Chemotherapy — Thu, 25 Jun 2009 07:22:26 +0100

Abstract Subpopulations of regular and atypical lymphocytes in the peripheral blood of a 24-year-old man with an infectious mononucleosis (IM)-like syndrome associated with hepatitis A virus (HAV) infection were analyzed. The ratio of CD4+ to CD8+ cells was in the normal range (1.19 and 1.23 in the regular and atypical lymphocytes, respectively), with no increase in CD8+ cells. The percentage of CD8+/CD11b- cells was not increased in the atypical lymphocytes. However, CD45RO+ was expressed on 86.3% of CD4+ atypical lymphocytes. The present data suggest that atypical lymphocytes expressing CD4+/CD45RO+ may play the role of helper T cells in the immune system in the development of IM-like syndrome associated with HAV infection. Content Type Journal ArticleCategory Case Rep...

Cytomegalovirus and Epstein-Barr virus coinfection in three toddlers with prolonged illnesses

Journal of Medical Virology — Mon, 22 Jun 2009 23:00:00 +0100

Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) usually cause primary and latent infections during childhood; thus, coinfection with these viruses occurs occasionally in children. However, its clinical impact has not been established, and may be underestimated. Three cases of coinfection involving these two viruses in toddlers are described: a 14-month-old male with infectious mononucleosis, an 18-month-old female with hemophagocytic lymphohistiocytosis, and a 13-month-old female with acute hepatitis. All three patients had prolonged illnesses. Serial serological testing and quantitation of viral DNA for CMV and EBV using peripheral blood from the patients suggested primary infections with both viruses. In all three cases, the viral load of EBV and CMV in the early stage of disease exce...

Epstein-Barr virus colonization of tonsillar and peripheral blood B-cell subsets in primary infection and persistence

Blood — Wed, 17 Jun 2009 23:00:00 +0100

We report 2 findings consistent with this latter view. First, we examined circulating non–isotype-switched (IgD+CD27+) memory cells, a population that much evidence suggests is GC-independent in origin. Whereas isotype-switched memory had the highest viral loads by quantitative polymerase chain reaction, EBV was detectable in the nonswitched memory pool both in infectious mononucleosis (IM) patients undergoing primary infection and in most long-term virus carriers. Second, we examined colonization by EBV of B-cell subsets sorted from a unique collection of IM tonsillar cell suspensions. Here viral loads were concentrated in B cells with the CD38 marker of GC origin but lacking other GC markers CD10 and CD77. These findings, supported by histologic evidence, suggest that EBV infection...

Infliximab: Atypical infectious mononucleosis: case report

Reactions — Wed, 17 Jun 2009 00:53:50 +0100

(Source: Reactions)

Infliximab: Atypical infectious mononucleosis: case report.

Reactions Weekly — Mon, 15 Jun 2009 20:10:02 +0100

Page: 19 (Source: Reactions Weekly)

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The Overly Empathic White Knight

Psychology Today Addiction Center — Wed, 10 Jun 2009 05:51:02 +0100

Rescuer Subtypes: The Overly Empathic White KnightAfter reviewing the commonalities and differences among rescuers, we created four subtypes - the overly empathic white knight, the tarnished white knight, the terrorizing/terrified white knight, and the balanced rescuer. These subtypes are not discrete entities but represent our observation of clusters of characteristics that can overlap. In this blog, we will focus on the overly empathic white knight.The overly empathic white knight fears emotional distance. This fear can be triggered by many sources, such as separation, loss of love, or loss of approval. She tries to maintain or restore an emotional connection to her partner by positively affecting her partner's emotions through being needed, good, or caregiving. Sexual ...

Azathioprine: Fatal EBV mononucleosis, histiocystosis and B cell lymphoproliferative disorder: case report

Reactions — Tue, 09 Jun 2009 16:41:07 +0100

(Source: Reactions)

Differential diagnosis of hepatitis E virus, cytomegalovirus and Epstein-Barr virus infection in patients with suspected hepatitis E

Journal of Clinical Virology — Mon, 08 Jun 2009 23:00:00 +0100

Conclusions: Since infection by these herpesviruses may produce acute hepatitis, such event can cause diagnostic mistakes and should be investigated in patients positive for anti-HEV IgM and negative for HEV RNA. (Source: Journal of Clinical Virology)

Azathioprine: Fatal EBV mononucleosis, histiocystosis and B cell lymphoproliferative disorder: case report.

Reactions Weekly — Sun, 07 Jun 2009 18:23:59 +0100

Page: 9 (Source: Reactions Weekly)

EBV in MS: guilty by association?

Trends in Immunology — Sun, 31 May 2009 23:00:00 +0100

Authors: Lünemann JD, Münz C Epstein-Barr Virus (EBV) is one of the most successful human viruses, infecting more than 90% of the adult population worldwide and persisting for the lifetime of the host. Individuals with a history of symptomatic primary EBV infection, called infectious mononucleosis, carry a moderately higher risk of developing multiple sclerosis (MS). In addition, EBV-specific immune responses, which crucially regulate the host-virus balance in healthy virus carriers, are altered in patients with MS. Although no data so far unequivocally support a direct etiologic role of the virus, recent studies allow for the development of testable hypotheses as to how EBV infection potentially promotes autoimmunity and central nervous system (CNS) tissue damage in MS. ...

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[Cold urticaria associated with epstein barr virus mononucleosis.]

Actas Dermo-Sifiliograficas — Sun, 31 May 2009 23:00:00 +0100

Authors: Arias-Santiago SA, Almazán-Fernández FM, Burkhardt-Pérez P, Naranjo-Sintes R PMID: 19558926 [PubMed - in process] (Source: Actas Dermo-Sifiliograficas)

Rumpel–Leede sign in thrombocytopenia due to Epstein–Barr virus-induced mononucleosis

British Journal of Haematology — Tue, 26 May 2009 04:00:00 +0100

(Source: British Journal of Haematology)

First study to link the common CMV virus to high blood pressure

WorldHealth.net — Mon, 18 May 2009 16:38:23 +0100

By the age of 40, most people will have contracted the cytomegalovirus (CMV), a member of the herpes virus family that affects all age groups and causes congenital infection, mononucleosis and severe infection in transplant patients. It typically remains in a latent stage unless the immune system has been compromised, when it reemerges. In past studies, CMV has been linked to a condition in cardiac transplant patients in which the heart's arteries "reblock." It had also been linked to the development of atherosclerosis, the hardening of the heart's arteries. However, in both of these cases, scientists have not understood the mechanism behind these developments.Now, a new study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) has found that CMV can lead to hardening o...

Electronic Clinical Challenges and Images in GI

Gastroenterology — Mon, 11 May 2009 04:00:00 +0100

Question: A 17-year-old boy presented with a swollen head. One month earlier, he had been hit in the head with a basketball during a game, and he had developed progressive swelling a few days later. The patient did not have any history of bruising or bleeding except recurrent, self-limited epistaxis, but he did have a history of fever (up to 39°C), 30-kg weight loss, and pancytopenia (in the presence of trilineage cellular hypoplasia on bone marrow biopsy) that lasted 4 months after contracting infectious mononucleosis (seroconversion confirmed by positive immunoglobulin [Ig]M antibodies) treated with the antiviral agent cidofovir. The patient also had a prior history of refractory iron-deficiency anemia (not alleviated by oral iron therapy). The maternal grandfather (age 72 years) had th...

EBV-associated mononucleosis does not induce long-term global deficit in T-cell responsiveness to IL-15

Blood — Thu, 07 May 2009 04:00:00 +0100

It has been reported that infectious mononucleosis (IM)–symptomatic primary Epstein-Barr virus infection produces a global down-regulation of interleukin-15 receptor- (IL-15R) on T cells and natural killer cells associated with a defective IL-15 responsiveness that lasts for many years after the disease episode. In contrast with these results, our data indicate that, in the T-cell compartment derived from remote IM subjects, there is no quantitative or qualitative defect in the expression of the IL-15R chain and no deficit in T-cell responsiveness to IL-15. We observed efficient signal transduction, survival, and proliferation even in response to low IL-15 concentrations. These data are relevant and shed new light on the immune long-term response in IM subjects because they contradic...

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Being overweight can put girls at a higher risk of developing breast cancer later in life

WorldHealth.net — Tue, 05 May 2009 13:46:54 +0100

Researchers from the European Cancer Prevention Organization analyzed the diet and lifestyle habits of 1,146 girls from birth until 13. They found that a sedentary lifestyle, obesity and a diet heavy in simple carbohydrates are the three most significant predictors of early onset of puberty. And early puberty is linked with breast cancer, as the breast is most vulnerable at the start of development. As the researchers pointed out at the conference of the European Society for Medical Oncology, "Breast cancer seems to originate almost entirely in childhood. The breast is most vulnerable at the very onset of development. Further research should focus on nutrition in children and breast cancer risk to prevent the disease." In fact, research has shown that girls who are overweight at the age...

Poor Diet, Low Exercise Leads to Breast Cancer in Later Years

NaturalNews.com — Mon, 04 May 2009 07:00:00 +0100

(NaturalNews) A poor diet and a lack of exercise in childhood significantly increase a girl's risk of breast cancer later in life, according to the findings of a study conducted by researchers from the European Cancer Prevention Organization, presented at the conference of the European Society for Medical Oncology and published in the journal Pediatrics."Breast cancer seems to originate almost entirely in childhood," the researchers said. "The breast is most vulnerable at the very onset of development. Further research should focus on nutrition in children and breast cancer risk to prevent the disease." The researchers analyzed the diets and lifestyle habits of 1,146 girls from birth until the age of 13. They found that the three biggest predictors of an early onset of puberty in the girls...

Complete absence of KSHV/HHV-8 in posttransplant lymphoproliferative disorders: an immunohistochemical and molecular study of 52 cases.

American Journal of Clinical Pathology — Thu, 30 Apr 2009 23:00:00 +0100

Authors: Chen W, Huang Q, Zuppan CW, Rowsell EH, Cao JD, Weiss LM, Wang J Posttransplant lymphoproliferative disorders (PTLDs), a heterogeneous group of monoclonal or polyclonal lesions, occur in immunosuppressed patients after solid organ or bone marrow transplantation. Although most PTLDs are Epstein-Barr virus (EBV)+ and seem to represent EBV-induced proliferations of monoclonal (or less often polyclonal) B, T, or plasma cells, a subset of PTLDs is EBV-. Because Kaposi sarcoma-associated herpesvirus/human herpesvirus 8 (KSHV/HHV-8) has been described in association with the development of hematolymphoid and nonhematolymphoid neoplasms in HIV+ patients, we investigated whether there is an association between KSHV/HHV-8 and PTLDs. Formalin-fixed, paraffin-embedded tissue from 52 confi...

Generalized Wegener's granulomatosis in an immunocompetent adult after cytomegalovirus mononucleosis and bacterial urinary tract infection

Arthritis and Rheumatism — Wed, 29 Apr 2009 04:00:00 +0100

Human cytomegalovirus (HCMV) is frequently detected in autoimmune diseases, but its role in such disorders is poorly understood. Herein we describe the case of a young woman who developed generalized Wegener's granulomatosis (WG) after HCMV mononucleosis and urinary tract infection. During mononucleosis, the patient had extraordinarily high plasma levels of proinflammatory cytokines such as interleukin-5 and lymphotoxin [alpha], autoantibodies, and a higher blood level of viral DNA than were found in other immunocompetent patients infected with HCMV or healthy controls. Active HCMV replication was detected after the onset of vasculitis, and HCMV genomes or antigens were found in blood, urine, and inflammatory lesions on the kidney. Thus, HCMV may have triggered or exacerbated inflammation ...

Clopidogrel-Induced Hepatocellular Injury and Cholestatic Jaundice in an Elderly Patient: Case Report and Review of the Literature

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Mon, 27 Apr 2009 04:00:00 +0100

We describe a 78-year-old woman who underwent percutaneous coronary intervention with drug-eluting stents; clopidogrel and aspirin were started as antiplatelet therapy. Three weeks later, the patient developed mixed hepatocellular and cholestatic liver injury. Clopidogrel was discontinued, and her liver profile results began to improve. Her diagnostic work-up included screening for hepatitis, infectious mononucleosis, and rheumatologic diseases, as well as ultrasonography, magnetic resonance imaging, and endoscopic retrograde cholangiopancreaticography; all results were normal. On day 5 of hospitalization, because of the patient's risk for thrombosis secondary to the drug-eluting stents, clopidogrel was reintroduced; her liver enzyme levels increased. In the absence of any biliary obstruct...

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Infectious Exanthem

The American Journal of Medicine — Mon, 20 Apr 2009 16:14:31 +0100

Infectious exanthem is an acute generalized skin eruption associated with primary systemic infection. Common causes are adenovirus, cytomegalovirus, enterovirus, Epstein-Barr virus (infectious mononucleosis), human herpes 6 or 7 (roseola), human immunodeficiency virus (seroconversion syndrome), measles, parvovirus B19 (fifth disease), rubella, and West Nile virus. (Source: The American Journal of Medicine)

Epstein–Barr virus and multiple sclerosis

Journal of the Neurological Sciences — Sun, 12 Apr 2009 23:00:00 +0100

Abstract: Epstein–Barr virus (EBV) is a human DNA herpesvirus infecting more than 90% of the world's population. EBV is the etiological agent of infectious mononucleosis (Pfeiffer's disease). Furthermore, diverse malignancies such as Burkitt and Hodgkin lymphoma have been associated with EBV. More recently, a possible role for EBV has been suggested in chronic inflammatory/autoimmune diseases like rheumatoid arthritis and systemic lupus erythematosus as well as in multiple sclerosis (MS).MS is currently regarded as a disease with multifactorial etiology, EBV being one possible factor in MS manifestation: Infectious mononucleosis has been shown to increase the risk of developing MS later in life. EBV seroprevalence rates are higher in MS as compared to controls, in adult as well as in ped...

News From The Journal Of Clinical Investigation, April 1, 2009

Immune System / Vaccines News From Medical News Today — Fri, 03 Apr 2009 11:00:00 +0100

IMMUNOLOGY: Girls lacking the protein ITK at risk from fatal viral infection One of the most common viruses to infect humans is EBV. Although most people show no or few signs of infection, some develop glandular fever and boys with mutations in either one of two genes on the X-chromosome (SAP and XIAP) develop a fatal lymphoproliferative disease. (Source: Immune System / Vaccines News From Medical News Today)

Infectious mononucleosis screening in quinsy patients

European Archives of Oto-Rhino-Laryngology — Thu, 02 Apr 2009 05:51:18 +0100

Abstract There have been conflicting recommendations in the literature with regards to the screening of infectious mononucleosis (IM) in quinsy patients. Our aim was to ascertain an accurate rate of IM in quinsy patients and find any criterion by which we can decide which quinsy patient to screen for IM. We conducted a retrospective study on all quinsy patients admitted to our hospital in a 2-year period (374 patients) and detected the rate of IM to be at 4%. There were no IM-positive quinsy patients above the age of 30 in our study. Monocytosis was detected in 85% of the cases. This is the largest study evaluating the rate of IM in quinsy patients. Our study shows that a small minority of quinsy patients (4%) are IM positive. Routine screening of IM in quinsy patients mig...

Correlation between the immunological condition and the results of immunoenzymatic tests in diagnosing infectious mononucleosis.

Acta Bio-Medica : Atenei Parmensis — Tue, 31 Mar 2009 23:00:00 +0100

CONCLUSIONS: We show that, in paediatric patients, the detection of heterophil antibodies is not a very sensitive test, therefore the determination of immunoglobulins against specific antigens of EBV is recommended. PMID: 19705620 [PubMed - in process] (Source: Acta Bio-Medica : Atenei Parmensis)

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Infectious Mononucleosis Testing at the Point-of-Care.

Point of Care: The Journal of Near-Patient Testing & Technology — Sat, 07 Mar 2009 03:13:39 +0100

Page: 29DOI: 10.1097/POC.0b013e31819b2af7Authors: Russell, Barbara L. EdD, MT, SH *; Steele, John C. H. Jr MD, PhD + (Source: Point of Care: The Journal of Near-Patient Testing & Technology)

Possible Link Between Epstein-Barr Virus And Progression Of MS

Neurology / Neuroscience News From Medical News Today — Wed, 04 Mar 2009 09:00:00 +0100

Epstein-Barr virus (EBV), the pathogen that causes mononucleosis, appears to play a role in the neurodegeneration that occurs in persons with multiple sclerosis, researchers at the University at Buffalo and the University of Trieste, Italy, have shown. Multiple sclerosis (MS) is an autoimmune disease that can cause major disability. There currently is no cure. (Source: Neurology / Neuroscience News From Medical News Today)

[LETTERS] The dynamic DNA methylomes of double-stranded DNA viruses associated with human cancer

Genome Research — Mon, 02 Mar 2009 05:00:00 +0100

The natural history of cancers associated with virus exposure is intriguing, since only a minority of human tissues infected with these viruses inevitably progress to cancer. However, the molecular reasons why the infection is controlled or instead progresses to subsequent stages of tumorigenesis are largely unknown. In this article, we provide the first complete DNA methylomes of double-stranded DNA viruses associated with human cancer that might provide important clues to help us understand the described process. Using bisulfite genomic sequencing of multiple clones, we have obtained the DNA methylation status of every CpG dinucleotide in the genome of the Human Papilloma Viruses 16 and 18 and Human Hepatitis B Virus, and in all the transcription start sites of the Epstein-Barr Virus. Th...

Epstein-Barr virus may be associated with progression of MS

EurekAlert! - Infectious and Emerging Diseases — Mon, 02 Mar 2009 05:00:00 +0100

(University at Buffalo) Epstein-Barr virus, the pathogen that causes mononucleosis, appears to play a role in the neurodegeneration that occurs in persons with multiple sclerosis, researchers at the University at Buffalo and the University of Trieste, Italy, have shown. (Source: EurekAlert! - Infectious and Emerging Diseases)

Current insight on trends, causes, and mechanisms of Hodgkin's lymphoma.

Cancer Journal — Sun, 01 Mar 2009 00:00:00 +0100

Authors: Caporaso NE, Goldin LR, Anderson WF, Landgren O Hodgkin's lymphoma (HL) has a unique and distinct history, epidemiology, treatment, and biology. A viral agent or infectious agent has long been considered as the etiologic agent and Epstein-Barr virus is the main candidate for the infectious agent causing HL; however, Epstein-Barr virus genome is found within the tumor in only about 20% to 40% of HL cases with a prior diagnosis of infectious mononucleosis. Recently, autoimmune and related conditions have drawn attention to a potential role for immune-related and inflammatory conditions in the etiology and pathogenesis of the malignancy. Evidence from multiply-affected families, a twin study, a case-control study, and population-based registry studies implicate genetic factors. D...

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Medical history and risk of lymphoma: results of a European case–control study (EPILYMPH)

Journal of Cancer Research and Clinical Oncology — Wed, 11 Feb 2009 06:57:16 +0100

Conclusion Our results are consistent with the current knowledge about the association with mononucleosis as indicator of Epstein–Barr-virus infection, suggest serological study of the association to HBV infection and do not support the view of a positive association between rheumatoid arthritis and lymphoma risk. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00432-009-0551-2Authors Nikolaus Becker, German Cancer Research Center Division of Cancer Epidemiology Im Neuenheimer Feld 280 69120 Heidelberg GermanyJoan Fortuny, Catalan Institute of Oncology Unit of Infections and Cancer Barcelona SpainTomas Alvaro, Catalan Institute of Oncology Unit of Infections and Cancer Barcelona SpainAlexandra Nieters, German Cancer Research Center Division of Cance...

Association of Infectious Mononucleosis with Multiple Sclerosis

Neuroepidemiology — Tue, 10 Feb 2009 16:14:20 +0100

Neuroepidemiology 2009;32:257-262 (DOI:10.1159/000201564) (Source: Neuroepidemiology)

[LETTERS] The dynamic DNA methylomes of double-stranded DNA viruses associated with human cancer

Genome Research — Tue, 10 Feb 2009 05:00:00 +0100

Clinical analysis and follow-up study of chronic active Epstein-Barr virus infection in 53 pediatric cases.

Chinese Medical Journal — Thu, 05 Feb 2009 05:00:00 +0100

CONCLUSIONS: The study reveals that CAEBV in Chinese pediatric patients has a severe clinical course and prognosis is poor. Thrombocytopenia and decreases in albumin might potentially be risk factors for a poor prognosis. EBV loads should be measured and tissue should be stained on hybridization probes for EBV-encoded small RNA (EBER) if a patient presents with the known symptoms of CAEBV. PMID: 19236801 [PubMed - in process] (Source: Chinese Medical Journal)

Med Sci Monit 2009; 15(2):CS30-33 "Acute acalculous cholecystitis with pericholecystitis in a patient with Epstein-Barr Virus infectious mononucleosis"

Medical Science Monitor — Thu, 29 Jan 2009 21:05:00 +0100

Conclusions: Epstein-Barr virus infections are usually self-limited, and surgical treatment of acute acalculous cholecystitis should only be considered when the ultrasonographic criteria persist on follow-up examinations or when they deteriorate. This is the first report of a severe course of acute acalculous cholecystitis with suspected gallbladder perforation associated with infectious mononucleosis. (Source: Medical Science Monitor)

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Glandular fever and pulmonary artery thrombosis in a paraplegic patient, who had undergone splenectomy for splenic trauma sustained along with spinal cord injury: misdiagnosed initially as urine infection and later as lymphoma when CT scan revealed enlarged lymph nodes: a case report

Cases Journal — Thu, 22 Jan 2009 05:00:00 +0100

Conclusion: Learning points from this case: (1) Although routine administration of antibiotic to a spinal cord injury patient with pyrexia may be acceptable in outpatient setting, other possibilities such as infection by multi-drug resistant organism, viral infection, venous or, arterial thrombosis should be considered if a patient does not respond promptly to antibacterial therapy. (2) When full blood count showed lymphocytosis (comprising > 50% of white blood cells) with atypical morphology, lymphocyte surface markers, Paul Bunnell test, and Epstein Barr virus serology should be performed. These tests would have led to a diagnosis of infectious mononucleosis, and abdominal imaging studies could have been avoided. (3) Lymphoid hyperplasia is the hallmark of infectious mononucleosis; there...

Functional Epstein-Barr virus reservoir in plasma cells derived from infected peripheral blood memory B cells

Blood — Thu, 15 Jan 2009 05:00:00 +0100

The Epstein-Barr virus (EBV) causes infectious mononucleosis, establishes latency in resting memory B lymphocytes, and is involved in oncogenesis through poorly understood mechanisms. The EBV lytic cycle is initiated during plasma cell differentiation by mRNAs transcripts encoded by BZLF1, which induce the synthesis of EBV proteins such as the immediate-early antigen ZEBRA and the late membrane antigen gp350. Therefore, we assessed the capacity of circulating EBV-infected B lymphocytes from healthy EBV-seropositive subjects to enter and complete the EBV lytic cycle. Purified B lymphocytes were polyclonally stimulated and BZLF1- or gp350-secreting cells (BZLF1-SCs or gp350-SCs) were enumerated by ELISpot assays. The number of BZLF1-SCs ranged from 50 to 480/107 lymphocytes (median, 80; 25th...

Amoxicillin: Prurigo in a patient with infectious mononucleosis: case report

Reactions — Mon, 12 Jan 2009 06:17:37 +0100

(Source: Reactions)

Amoxicillin: Prurigo in a patient with infectious mononucleosis: case report.

Reactions Weekly — Sat, 10 Jan 2009 07:33:57 +0100

Page: 7 (Source: Reactions Weekly)

Pulmonary embolism and portal vein thrombosis in an immunocompetent adolescent with acute cytomegalovirus hepatitis

Journal of Thrombosis and Thrombolysis — Wed, 31 Dec 2008 10:11:43 +0100

We describe the case of an immunocompetent adolescent with acute cytomegalovirus hepatitis that was complicated with pulmonary embolism and portal vein thrombosis. To our knowledge, this is the first reported case in which these two thrombotic phenomena occurred simultaneously in an adolescent with no obvious predisposing factors for thrombosis in the setting of an acute CMV infection. Content Type Journal ArticleDOI 10.1007/s11239-008-0303-1Authors Antonio Mendoza Ladd, Lenox Hill Hospital Department of Internal Medicine New York NY USARakesh Goyal, Lenox Hill Hospital Department of Internal Medicine New York NY USALouis Rosainz, Lenox Hill Hospital Department of Internal Medicine New York NY USAPeter Baiocco, Lenox Hill Hospital Department of Internal Medicine New York NY USALarr...

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I know that ME exists ... I suffer from it twice a year, says G4 star Jonathan Ansell

the Mail online | Health — Sat, 27 Dec 2008 22:10:32 +0100

After being struck down by glandular fever as a student, singer Jonathan Ansell has suffered from chronic fatigue syndrome, also known as ME. He tells MoS how he has been able to resume a normal life. (Source: the Mail online | Health)

I know that ME exists ... I suffer from it twice a year, says G4 star Jonathan Ansell

the Mail online | Diet — Sat, 27 Dec 2008 22:10:32 +0100

[Original articles] Ultrasonographic evaluation of splenic enlargement in athletes with acute infectious mononucleosis

British Journal of Sports Medicine — Thu, 18 Dec 2008 05:00:00 +0100

Conclusions: The majority of athletes with IM experience a moderate degree of splenomegaly. Peak splenic enlargement occurs within 2 weeks from the time of symptom onset in most cases, but may extend to 3.5 weeks. The rate of splenic enlargement appears to be predictable for an individual who develops IM. Ultrasonographic data further show that splenomegaly associated with acute IM infection resolves within 4–6 weeks of symptom onset in the majority of cases. (Source: British Journal of Sports Medicine)

[Original articles] Ultrasonographic evaluation of splenic enlargement in athletes with acute infectious mononucleosis

British Journal of Sports Medicine — Thu, 18 Dec 2008 05:00:00 +0100

Atypical infectious mononucleosis in a patient receiving tumor necrosis factor alpha inhibitory treatment

Rheumatology International — Wed, 26 Nov 2008 19:58:04 +0100

The objective is to report a case of atypical acute infectious mononucleosis in a juvenile ankylosing spondylitis patient who was treated with infliximab. A 20-year-old man was hospitalized for the evaluation of lymphadenopathy and systemic symptoms. His symptoms developed at the eighth week of the infliximab treatment and he required hospitalization. Lymph node biopsy was performed and he was diagnosed as atypical infectious mononucleosis (absence of fever, pharyngitis, lymphocytosis and negative atypical lymphocytosis on blood smear). Infections have become major concerns in patients treated with TNF-blocking agents. In theoretical base, it is not surprising as TNF-α has a crucial role in the body’s defense against both bacterial and viral invasion. Blocking the action of TNF ma...

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[Emergency casebooks] Infective splenic rupture presenting with symptoms of a pulmonary embolism

Emergency Medicine Journal — Tue, 25 Nov 2008 05:00:00 +0100

Splenic rupture following infectious mononucleosis is rare. The case history is presented of a man who presented with sudden onset pleuritic left chest pain. An ultrasound scan of the abdomen showed an enlarged spleen with an abnormal echo pattern and a CT scan of the abdomen showed severe splenic rupture. The patient remembered that he had been unwell 2 weeks earlier with flu-like symptoms and enlarged cervical lymph nodes. Serological examination was positive for Ebstein-Barr virus, confirming the diagnosis of splenic rupture following splenomegaly due to infectious mononucleosis. Management was initially conservative but he became haemodynamically unstable and an emergency splenectomy was performed. (Source: Emergency Medicine Journal)

Should you use steroids to treat infectious mononucleosis?

The Journal of Family Practice — Sat, 01 Nov 2008 04:00:00 +0100

Authors: Dickens KP, Nye AM, Gilchrist V, Rickett K, Neher JO Studies of steroids to treat infectious mononucleosis have found no significant effect on the clinical course of the illness at 1 to 3 months (strength of recommendation [SOR]: 1 randomized controlled trial [RCT] and 1 nonrandomized double-blind trial). Although steroids have been shown to improve resolution of hematologic abnormalities, fever, and white blood cell count, and may shorten length of infirmary stay (SOR: 1 nonrandomized double-blind trial and 1 RCT), no significant difference was found in resolution of symptoms with or without steroids (SOR: 2 RCTs). PMID: 19006627 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical inquiries. Should you use steroids to treat infectious mononucleosis?

The Journal of Family Practice — Sat, 01 Nov 2008 04:00:00 +0100

Authors: Dickens KP, Nye AM, Gilchrist V, Rickett K, Neher JO PMID: 19006627 [PubMed - in process] (Source: The Journal of Family Practice)

CD34+ Cord Blood Cell-Transplanted Rag2-/- {gamma}c-/- Mice as a Model for Epstein-Barr Virus Infection.

The American Journal of Pathology — Thu, 09 Oct 2008 04:00:00 +0100

Authors: Cocco M, Bellan C, Tussiwand R, Corti D, Traggiai E, Lazzi S, Mannucci S, Bronz L, Palummo N, Ginanneschi C, Tosi P, Lanzavecchia A, Manz MG, Leoncini L Recent studies suggest that Epstein-Barr virus (EBV) can infect naïve B cells, driving them to differentiate into resting memory B cells via the germinal center reaction. This hypothesis has been inferred from parallels with the biology of normal B cells but has never been proven experimentally. Rag2(-/-) gammac(-/-) mice that were transplanted with human CD34(+) cord blood cells as newborns were recently shown to develop human B, T, and dendritic cells, constituting lymphoid organs in situ. Here we used this model to better define the strategy of EBV infection of human B cells in vivo and to compare this model system wit...

Acute renal failure and rhabdomyolysis in a patient with infectious mononucleosis: a case report

Cases Journal — Tue, 07 Oct 2008 04:00:00 +0100

We report a very rare case of acute renal failure and rhabdomyolysis in an Intensive Care treated 20-years-old male with upper airway obstruction due to Epstein-Barr infection. In our opinion this was a manifestation of the very rare and potentially lethal propofol infusion syndrome and not a direct complication of the underlying infection, although renal biopsy was not performed in our patient. (Source: Cases Journal)

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Severe cytomegalovirus (CMV) community-acquired pneumonia (CAP) precipitating a systemic lupus erythematosus (SLE) flare

Heart & Lung — Sun, 05 Oct 2008 23:00:00 +0100

We present the case of a 40-year-old woman with SLE who presented with severe CMV CAP. CMV infection was suspected because of 2 nonspecific laboratory findings: increased serum transaminases and atypical lymphocytes in the peripheral smear. SLE is a multisystem autoimmune disorder that spares the liver. Therefore, in a patient with SLE who experiences an SLE flare, increased serum transaminases should suggest the possibility of CMV. In patients with SLE with flare, the likelihood of CMV is further increased if serum transaminases are elevated with atypical lymphocytes and should prompt specific testing for CMV. This patient's severe CMV CAP was treated successfully with oral valganciclovir, and she made a slow but complete recovery. (Source: Heart & Lung)

A Remote Fuzzy Multicriteria Diagnosis of Sore Throat

Telemedicine and e-Health — Thu, 25 Sep 2008 19:53:33 +0100

Telemedicine and e-Health Sep 2008, Vol. 14, No. 7: 656-665. Fuzzy set theory was applied to determining the presence of a streptococcal infection. Using five diagnostic management strategies (no test no Rx; rapid strep; culture; rapid strep and culture; and empiric Rx) for treating a sore throat, three clinical scenarios were conducted, each with three possible ratings (low, moderate, and high). The overall goal was to determine the optimal treatment option. A multicriteria analysis using fuzzy reasoning could be utilized to determine optimal treatment.A sore throat (also known as pharyngitis or tonsillitis) is most commonly caused by a contagious viral infection (such as the flu, cold, or mononucleosis), although more serious throat infections can be caused by a bacterial infection ...

Ultrasonographic Evaluation of Splenic Enlargement in Athletes with Acute Infectious Mononucleosis.

British Journal of Sports Medicine — Thu, 18 Sep 2008 04:00:00 +0100

CONCLUSIONS: The majority of athletes with IM experience a moderate degree of splenomegaly. Peak splenic enlargement occurred within two weeks from the time of symptom onset in most cases, but may extend to 3.5 weeks. The rate of splenic enlargement appears to be predictable for an individual who develops IM. Ultrasonographic data further show that splenomegaly associated with acute IM infection resolves within 4-6 weeks of symptom onset in the majority of cases. PMID: 18801776 [PubMed - as supplied by publisher] (Source: British Journal of Sports Medicine)

Immunological aspects of chronic fatigue syndrome.

Autoimmunity Reviews — Mon, 15 Sep 2008 04:00:00 +0100

Authors: Lorusso L, Mikhaylova SV, Capelli E, Ferrari D, Ngonga GK, Ricevuti G Chronic fatigue syndrome (CFS) is a specific clinical condition that characterises unexplained disabling fatigue and a combination of non-specific accompanying symptoms for at least 6 months, in the absence of a medical diagnosis that would otherwise explain the clinical presentation. Other common symptoms include headaches, myalgia, arthralgia, and post-exertional malaise; cognitive difficulties, with impaired memory and concentration; unrefreshing sleep; and mood changes. Similar disorders have been described for at least two centuries and have been differently named neurasthenia, post-viral fatigue, myalgic encephalomyelitis and chronic mononucleosis. Recent longitudinal studies suggest that some people a...

A mechanism for the HLA-A*01-associated risk for EBV+ Hodgkin lymphoma and infectious mononucleosis

Blood — Mon, 08 Sep 2008 04:00:00 +0100

(Source: Blood)

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Clinical Criteria Key to Post-Mono Sports Return

Pediatric News — Mon, 01 Sep 2008 04:00:00 +0100

VANCOUVER, B.C. — Physical findings, laboratory values, and imaging results are of little use in determining when it is safe for young athletes with infectious mononucleosis to return to play. Ultimately, the decision on how long to keep them away from physical activity is a clinical one, according to a pediatric sports medicine specialist. (Source: Pediatric News)

Sports medicine pearls and pitfalls — defending the spleen: Return to play after infectious mononucleosis

Current Sports Medicine Reports — Sat, 30 Aug 2008 15:18:23 +0100

Content Type Journal ArticleDOI 10.1007/BF02941142Authors E. Randy Eichner, University of Oklahoma 180 W. Brooks 73109 Norman OK USA Journal Current Sports Medicine ReportsOnline ISSN 1537-8918Print ISSN 1537-890X Journal Volume Volume 6 Journal Issue Volume 6, Number 2 / April, 2007 (Source: Current Sports Medicine Reports)

Review paper DIHS – drug-induced hypersensitivity syndrome – an update with special emphasis on the role of herpesviruses in syndrome aetiopathogenesis

Articles of Advances in Dermatology and Allergology - TERMEDIA publishing house — Mon, 25 Aug 2008 12:26:01 +0100

The first cases of DIHS were described almost 70 years ago, but so far elucidation of its aetiopathogenesis has remained a challenge for researchers. DIHS can be distinguished from other types of drug eruptions by the limited number of culprit drugs, delayed onset in relation to the introduction of causative medication and also clinical similarity to infectious mononucleosis. Besides the undoubtedly crucial role of exposure to the causative drug, it seems that another important element of DIHS pathogenesis is reactivation of human herpes virus-6 (HHV-6) and possibly other viruses included in this group. DIHS patients present an increased level of anti-viral IgG after approximately 3 weeks from the onset of symptoms, and furthermore viral DNA can be detected in patients’ blood and ski...

Splenic infarction in a patient with hereditary spherocytosis, protein C deficiency and acute infectious mononucleosis

European Journal of Pediatrics — Wed, 06 Aug 2008 05:49:27 +0100

Content Type Journal ArticleCategory ErratumDOI 10.1007/s00431-008-0807-xAuthors Christian Breuer, University Children’s Hospital, Heinrich-Heine-University Pediatric Infectious Diseases, Department of General Pediatrics Dusseldorf GermanyGisela Janssen, University Children’s Hospital, Heinrich-Heine-University Department for Pediatric Oncology, Hematology and Immunology Dusseldorf GermanyHans-Jürgen Laws, University Children’s Hospital, Heinrich-Heine-University Department for Pediatric Oncology, Hematology and Immunology Dusseldorf GermanyJörg Schaper, University Children’s Hospital, Heinrich-Heine-University Department for Pediatric Radiology Dusseldorf GermanyErtan Mayatepek, University Children’s Hospital, Heinrich-Heine-University Pediatric Infectious Diseases, Depart...

Follicular lymphoma in a X-linked lymphoproliferative syndrome carrier female.

Scandinavian Journal of Immunology — Fri, 01 Aug 2008 04:00:00 +0100

This report describes a female carrier with an XLP phenotype who was retrospectively identified after her grandson died from the disorder. Subsequent genetic testing identified the patient's mother and affected maternal grandmother as XLP carriers. The family's medical records were significant. The proband had lymphoma at ages 2 and 8 and made a full recovery following treatment. Both the maternal grandmother and uncle died of non-Hodgkin's lymphoma. We were concerned that the XLP carrier mother may be predisposed to lymphoma if the normal X chromosome is skewed towards inactivation. The human androgen receptor assay detected random X chromosome inactivation in the carrier mother. EBV was not detected in the lymphoma tissues of the proband and his grandmother, confirming previous findings ...

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New Topic Page: Sore Throat

What's New on MedlinePlus — Fri, 25 Jul 2008 04:00:00 +0100

Visit the new MedlinePlus Health Topic page on sore throat. Your throat is a tube that carries food to your esophagus and air to your windpipe and larynx. The technical name for throat is pharynx. You can have a sore throat for many reasons. Often, colds and flu cause sore throats. Other causes can include allergies; mononucleosis; smoking; strep throat; or tonsillitis - an infection in the tonsils... (Source: What's New on MedlinePlus)

Breast cancer and microbial cancer incidence in female populations around the world: a surprising hyperbolic association.

Cancer Control — Sun, 20 Jul 2008 07:19:31 +0100

We examined age-adjusted BC and MC incidence rates in 74 female populations around the world with cancer registries. Our analysis suggests that BC and MC rates are inversely associated in a special mathematical form such that the product of BC rate and MC rate is approximately constant across world female populations. A differential equation model with solutions consistent to the observed inverse association was derived. BC and MC rates were modeled as functions of an exposure level to unspecified common factors that influence the 2 rates. In conjunction with previously reported evidence, we submit a hypothesis that BC etiology may have an appreciable link with microbial exposures (and/or immunological responses to them), the lack of which, especially in early life, may elevate BC risk. ...

Mononucleosis: Can it recur?

MayoClinic.com Full Feed — Fri, 18 Jul 2008 05:00:00 +0100

Rarely, mononucleosis can recur. Learn more about causes and complications.Sponsored by:Chemotherapy.com - http://www.chemotherapy.com (Source: MayoClinic.com Full Feed)

Mononucleosis: Can it recur?

MayoClinic.com - Ask a Specialist — Fri, 18 Jul 2008 05:00:00 +0100

Rarely, mononucleosis can recur. Learn more about causes and complications.Sponsored by:Chemotherapy.com - http://www.chemotherapy.com (Source: MayoClinic.com - Ask a Specialist)

Mononucleosis and Athletic Participation: An Evidence-Based Subject Review.

Clinical Journal of Sport Medicine — Wed, 09 Jul 2008 23:38:22 +0100

Page: 309DOI: 10.1097/JSM.0b013e31817e34f8Authors: Putukian, Margot MD; O'Connor, Francis G MD, MPH; Stricker, Paul MD; McGrew, Christopher MD; Hosey, Robert G MD; Gordon, Steven M MD; Kinderknecht, James MD; Kriss, Vesna MD; Landry, Gregory MD (Source: Clinical Journal of Sport Medicine)

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Splenic infarction in a patient hereditary spherocytosis, protein C deficiency and acute infectious mononucleosis

European Journal of Pediatrics — Sat, 05 Jul 2008 06:22:52 +0100

We report a 13-year-old male with HS who was referred to our hospital with a 4-day history of fever and left upper quadrant pain. Ultrasound scans and magnetic resonance imaging showed lesions suggestive of splenic infarction. Initially, antibiotic treatment was started because secondary infection was suspected. However, 1 week after admission the patient developed typical clinical signs of acute infectious mononucleosis. Further laboratory work up confirmed the diagnosis of acute Epstein–Barr virus infection and additionally revealed protein C deficiency. This association has not been reported previously and may have contributed to the development of splenic infarction. Since infectious mononucleosis is a common cause for clinical consultations in adolescence, physicians caring fo...

Infectious Mononucleosis

MedicineNet Kids Health General — Wed, 02 Jul 2008 07:00:00 +0100

Title: Infectious MononucleosisCategory: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 7/2/2008 (Source: MedicineNet Kids Health General)

Tonsillar Lesions of Infectious Mononucleosis Resembling MALT Type Lymphoma. A Report of Two Cases.

Pathology Oncology Research — Tue, 01 Jul 2008 04:00:00 +0100

We report here, two cases of tonsillar lesion of IM resembling marginal zone B-cell lymphoma mucosa-associated lymphoid tissue (MALT) type. The patients consisted of an 18-year-old Japanese woman and a 36-year-old Japanese man. Both patients presented with tonsillar mass. Histologically, in one case, the tonsil showed diffuse proliferation of medium-sized lymphocytes. The medium-sized lymphocytes had round or slightly indented nuclei with a small solitary nucleoli and abundant clear cytoplasm and somewhat resembled monocytoid B-cells. In the remaining one case, the lymphoid follicles had hyperplastic germinal centers with ill-defined borders surrounded by a sheet-like proliferation of polymorphous infiltration showing a marginal zone distribution pattern. On high-power field, the interfoll...

Mononucleosis

MayoClinic.com Full Feed — Sat, 28 Jun 2008 05:00:00 +0100

— Comprehensive overview covers symptoms and treatment of kissing disease in adults and children.Sponsored by:Chemotherapy.com - http://www.chemotherapy.com (Source: MayoClinic.com Full Feed)

Detailed analysis of Epstein–Barr virus-specific CD4+ and CD8+ T cell responses during infectious mononucleosis

Clinical and Experimental Immunology — Wed, 11 Jun 2008 12:52:39 +0100

Clinical & Experimental Immunology, Volume 0, Issue 0, Page ???, September 2003. Summary We studied simultaneously Epstein–Barr virus (EBV)-specific CD4+ and CD8+ T cell responses during and after infectious mononucleosis (IM), using a previously described 12-day stimulation protocol with EBNA1 or BZLF1 peptide pools. Effector ... (Source: Clinical and Experimental Immunology)

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HLA Class II Alleles and the Presence of Circulating Epstein-Barr Virus DNA in Greek Patients with Nasopharyngeal Carcinoma

Strahlentherapie und Onkologie — Fri, 06 Jun 2008 05:54:34 +0100

Conclusion: Circulating EBV-DNA and specific HLA class II alleles may predispose to or protect from NPC. However, the results of this study suggest that the genetic predisposition of an individual to NPC is independent of the liability to EBV infection. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00066-008-1816-4Authors Charisios Karanikiotis, 424 Army General Hospital Thessaloniki GreeceMichail Daniilidis, Aristotle University of Thessaloniki School of Medicine AHEPA Hospital GreeceNikolaos Karyotis, Aristotle University of Thessaloniki School of Medicine AHEPA Hospital GreeceCharalambos Bakogiannis, Hygeia Hospital Athens GreeceTheofanis Economopoulos, “Attikon” University Hospital Athens GreeceSamuel Murray, Metropolitan Hospital Athens Gre...

Breast cancer and microbial cancer incidence in female populations around the world: A surprising hyperbolic association

International Journal of Cancer — Fri, 06 Jun 2008 04:00:00 +0100

Epstein-Barr virus nuclear antigen-2 detection and typing in immunocompromised children correlated with lymphoproliferative disorder biopsy findings.

Braz J Infect Dis — Sun, 01 Jun 2008 04:00:00 +0100

Authors: Mendes TM, de Oliveira LC, Yamamoto L, Del Negro GM, Okay TS Epstein-Barr virus (EBV), the causative agent of infectious mononucleosis, plays a significant role as a cofactor in the process of tumorigenesis, and has consistently been associated with a variety of malignancies especially in immunocompromised patients. Forty-four children and adolescents (21 liver transplant patients, 7 heart transplant, 5 AIDS, 3 autoimmune hepatitis, 2 nephritic syndromes, 2 medullar aplasia, 2 primary immunodeficiency disorder patients, 1 thrombocytopenic purpura and 1 systemic lupus erythematosus) presenting with chronic active EBV infection (VCA-IgM persistently positive; VCA-IgG > 20 AU/mL and positive IgG _ EBNA) had peripheral blood samples obtained during clinically characterized EBV ...

Pharyngitis of infectious mononucleosis: computed tomography findings

Radiation Medicine — Thu, 29 May 2008 05:58:22 +0100

Abstract Two women presented with sore throat and fever. Their symptoms were not alleviated by antibiotics. Cervical computed tomography (CT) with contrast enhancement demonstrated enlargement of predominant posterior cervical lymph nodes and streaky heterogeneous tonsils with interspersed low attenuation. They were diagnosed as having infectious mononucleosis by their laboratory data. Thus, when radiologists encounter these CT findings of pharyngitis that is not alleviated by antibiotic therapy, infectious mononucleosis should be considered in the differential diagnosis. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11604-007-0221-8Authors Naoki Kutuya, Juntendo University School of Medicine Department of Radiology 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421 J...

Review: Corticosteroids in treating infectious diseases

NeLM Headline News — Tue, 27 May 2008 00:00:00 +0100

A review published in the Archives of Internal Medicine has found that corticosteroids are safe and useful for a wide variety of infections. However courses longer than three weeks should be withheld from HIV-infected patients with low CD4 counts The review analysed randomised controlled studies comparing corticosteroids and placebo in infections. All patients also received active antimicrobial agents in addition to placebo or corticosteroids other than some trials of viral infections, sore throat, and cerebral cysticercosis. The reviewers split the various infectious diseases into the five groups listed below depending on the outcomes observed when patients were treated with corticosteroids: Group 1 – improved with corticosteroid treatment (patients with bacterial meningitis, tuberc...

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Symptomatic atrial fibrillation with infectious mononucleosis.

Canadian Family Physician Medecin de Famille Canadien — Thu, 01 May 2008 04:00:00 +0100

Authors: Aghenta A, Osowo A, Thomas J PMID: 18474702 [PubMed - indexed for MEDLINE] (Source: Canadian Family Physician Medecin de Famille Canadien)

Evaluation of commercial EBV RecombLine assay for diagnosis of nasopharyngeal carcinoma.

Journal of Clinical Virology — Wed, 30 Apr 2008 04:00:00 +0100

CONCLUSION: In high incidence NPC regions with low incidence IM yet high prevalence of EBV infection, both RecombLine IgG and IgA tests provide a useful alternative to the more complex cell-extract based immunoblot assay as confirmation test for NPC diagnosis in particular when using EA and EBNA1 as discriminators in IgG and IgA testing, respectively. PMID: 18455473 [PubMed - as supplied by publisher] (Source: Journal of Clinical Virology)

Severe lactic acidosis secondary to minocycline in a teenager with infectious mononucleosis and mitochondrial myopathy.

Clinical Neurology and Neurosurgery — Fri, 25 Apr 2008 04:00:00 +0100

We report an interesting case of a teenager in which mitochondrial myopathy with severe lactic acidosis presented following a bout of infectious mononucleosis and minocycline use. It is hypothesized that oxidative stress from the infectious illness plus the minocycline use triggered the patient's presentation. The clinical manifestations and genetics of mitochondrial myopathies and treatment are discussed along with the management of lactic acidosis. PMID: 18440128 [PubMed - as supplied by publisher] (Source: Clinical Neurology and Neurosurgery)

Antibodies specific for human T lymphocytes in cold agglutinin and lymphocytotoxic sera

European Journal of Immunology — Wed, 16 Apr 2008 04:00:00 +0100

Sera of patients with cold agglutinin disease (anti-I,i), systemic lupus erythematosus, infectious mononucleosis or cryoglobulinemia contained cold IgM antibodies cytotoxic for a subpopulation of normal lymphocytes. Evidence was obtained that the antibodies were specific for T lymphocytes. There was an enrichment of cells reacting with the sera after removal of Ig-bearing cells on immuno adsorbent columns. Absorption studies with adult and cord erythrocytes revealed a minimum of three antigenic determinants on the lymphocyte membrane, viz. i,I and a third specificity which was unique to T cells. Antibodies to this third specificity were present, at high titer, in sera which were monoclonal for the i antigen. (Source: European Journal of Immunology)

Erratum for Hadinoto et al. On the dynamics of acute EBV infection and the pathogenesis of infectious mononucleosis. Blood. 2008;111:1420-1427.

Blood — Tue, 08 Apr 2008 04:00:00 +0100

(Source: Blood)

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Cytomegalovirus mononucleosis after percutaneous injury in a Thai medical student.

American Journal of Infection Control — Sat, 29 Mar 2008 22:05:24 +0100

Authors: Apisarnthanarak A, Mundy LM PMID: 18371522 [PubMed - in process] (Source: American Journal of Infection Control)

Comparison of pathogenic properties of the murid gammaherpesvirus (MuHV 4) strains: a role for immunomodulatory proteins encoded by the left (5′-)end of the genome

Central European Journal of Biology — Fri, 15 Feb 2008 17:58:45 +0100

Abstract The murid herpesvirus 4 (MuHV 4) species encompasses 7 isolates, out of which at least two (MHV-68, MHV-72) became in vitro propagated laboratory strains. Following intranasal inoculation, MuHV 4 induces an acute infectious mononucleosis-like syndrome with elevated levels of peripheral blood leukocytes, shifts in the relative proportion of lymphocytes along with the appearance of atypical mononuclear cells. At least two isolates exhibited spontaneous deletions at the left hand (5′-end) of their genome, resulting in the absence of M1, M2, M3 genes (strain MHV-72) and also of the M4 gene (strain MHV-76). Based on DNA sequence amplifications only, another two isolates (MHV-Šum and MHV-60) were shown to possess similar deletions of varying length. During latency (un...

What Causes Nosebleeds?

PediatricEducation.org — Mon, 11 Feb 2008 20:57:08 +0100

Discussion The nose has a rich vascular supply. The Kiesselbach plexus, or Little area, is located on the anterior septum forming a vascular plexus that is easily traumatized. This is the most common location causing epistaxis in the anterior nose. Epistaxis is a common complaint whose cause is often easily identifiable and usually easily treated. However, parents may be quite distressed because their "child is bleeding" and may feel inadequate to stop it or feel that it happens too frequently. Epistaxis often will spontaneously resolve or will resolve with direct pressure to the nose. These nosebleeds usually require no further treatment. Active bleeding should be treated by placing the child in the upright position leaning slightly forward with a basin or tissue to capture the blood. ...

Epstein-Barr virus vaccine gives hope for infectious mononucleosis

Inpharma — Sun, 10 Feb 2008 07:50:40 +0100

(Source: Inpharma)