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Harrison's Principles of Internal Medicine, 18e
| Part 8. Infectious Diseases > Section 12. Infections Due to DNA Viruses > |
Chapter 181. Epstein-Barr Virus Infections, Including Infectious Mononucleosis
Sections: Epstein-Barr Virus Infections, Including Infectious Mononucleosis: Introduction, Further Readings.
Topics Discussed: epstein-barr virus infections; herpesvirus 4, human; mononucleosis, infectious.
Excerpt:"Epstein-Barr virus (EBV) is the cause of heterophile-positive infectious mononucleosis (IM), which is characterized by fever, sore throat, lymphadenopathy, and atypical lymphocytosis. EBV is also associated with several human tumors, including nasopharyngeal carcinoma, Burkitt's lymphoma, Hodgkin's disease, and (in patients with immunodeficiencies) B cell lymphoma. The virus is a member of the family Herpesviridae. The two types of EBV that are widely prevalent in nature are not distinguishable by conventional serologic tests.Most EBV infections in infants and young children either are asymptomatic or present as mild pharyngitis with or without tonsillitis. In contrast, up to 75% of infections in adolescents present as IM. IM in the elderly presents relatively often as nonspecific symptoms, including prolonged fever, fatigue, myalgia, and malaise. In contrast, pharyngitis, lymphadenopathy, splenomegaly, and atypical lymphocytes are relatively rare in elderly patients.The heterophile test is used for the diagnosis of IM in children and adults (Table 181–2). In the test for this antibody, human serum is absorbed with guinea pig kidney, and the heterophile titer is defined as the greatest serum dilution that agglutinates sheep, horse,..."
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