Epstein-Barr Virus (EBV) Infection
EBV or Epstein Barr Virus is the main agent that contribute to infectious mononucleosis (It cause 90% of the disease). Acute infectious mononucleosis presents with a history of 1-2 weeks of fatigue and malaise. However, onset may be abrupt. The incubation period in adolescents is 30-50 days. In young children, the incubation period is shorter. Most of the time, the course of this disease is benign and the prognosis is good.
Signs and symptoms:
- sore throat
- headache
- high grade fever
- myalgias (muscle pain)
- nausea
- abdominal pain
- splenomegaly (spleen enlargement)
- hepatomegaly (liver enlargement)
- pharyngitis (inflammation of the pharynx)
- Lymphadenopathy
- Maculopapular rash
- Eyelid edema
Investigations:
- Classic criteria: The 3 classic criteria for laboratory confirmation of acute infectious mononucleosis include (1) lymphocytosis, (2) the presence of at least 10% atypical lymphocytes on peripheral smear, and (3) a positive serologic test result for Epstein-Barr virus (EBV).
- Full blood count
- Liver function test – most patients have elevated liver function test results.
- Heterophile antibody test – Epstein-Barr virus infection stimulates polyclonal secretion of antibodies by infected B cells, including transient production of heterophile antibodies.
- Epstein-Barr virus serology
Complications:
- Hepatitis develops in more than 90% of patients with infectious mononucleosis.
- Approximately 50% of patients with infectious mononucleosis develop mild thrombocytopenia.
- Hemolytic anemia occurs in 0.5-3% of patients with infectious mononucleosis.
- Upper airway obstruction due to hypertrophy of tonsils and other lymph nodes in the Waldeyer ring ( 0.1-1% of patients).
- Splenic rupture (0.1-0.2% of patients with infectious mononucleosis).
- Hematologic complications (e.g.: hemophagocytic syndrome)
- Neurologic complications are rare (<1% of patient with EBV infection):
- Cardiac and pulmonary complications – rare
- Autoimmune complications like autoimmune diseases and Reye syndrome.
Treatment:
- Treatment is supportive
- Corticosteroids (potent anti-inflammatory drugs) – used to modify the immune response, however, it do not significantly alter the course of infectious mononucleosis
- Acyclovir (is the only antiviral drug used to treat infectious mononucleosis in placebo-controlled clinical trials)
- Intravenous immunoglobulin is used to modulate immune function in the presence of autoantibodies. It has been used successfully in the treatment of immune thrombocytopenia associated with infectious mononucleosis.
- Splenic rupture is one of the complication of infectious monnucleosis. It is an acute abdominal emergency and usually requires surgical intervention.
Reference
- http://www.emedicine.com/ped/topic705.htm
- Clinical Handbooks of Pediatrics. 3rd Edition. Lippincott Williams and Wilkins.
Tags: EBV, Epstein-Barr Virus, health, hepatomegaly, infectious mononucleosis, jaundice, splenomegaly
Technorati Tags: EBV, Epstein-Barr Virus, health, hepatomegaly, infectious mononucleosis, jaundice, splenomegaly
The problem with a disease like this is so many people don’t believe in it, and so the sufferers not only have to fight the disease, but also the indifference of others.
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Hmm.. This is the whole point why I start this blog after all. I believe that knowledge is the best medicine and prevention is better than cure. With some information, the sufferers have some idea about their illness and what options they might have. The best part is people around them have an oppurtunity to see what is their love one is going through. This will lead for better understanding.
Thanks for the information..This is very helpful!!
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In severe cases, corticosteroids may be used to reduce swelling of the throat, tonsils, or spleen. This type of steroid use may also decrease the overall length and severity of illness from infectious mono.