EBV disease + infectious mononucleosis

Question 1

How common is EBV?

Answer 1

Approx. 90-95% of the world population is EBV seopositive. Most commonly in teens and young adults (15-24 years of age)

Question 2

What causes EBV?

Answer 2

Epstein-barr virus, also know as human herpes virus 4

Question 3

Transmission of EBV?

Answer 3

Saliva, often referred to as kissing-disease

Question 4

Incubation period of EBV?

Answer 4

4-6 weeks

Question 5

Clinical features of EBV?

Answer 5

Young children are often asymptomatic.

Symptoms lasts for 2-4 weeks ( but the fatigue and hepatosplenomegaly may take months to resolve)

• Splenomegaly
• Hepatomegaly
• Fatigue
• Malaise
• Pharyngitis
• Tonsillitis with pus
• Palatal petechiae
• Bilateral cervical lymphadenopathy
• Abdominal pain
• Maculopapular rash similar to measles ( occurs in only a few cases causes of administration of aminopenicillin)
• Hoagland sign = early manifestation

Question 6

Diagnosis of EBV?

Answer 6

• Monospot test = detects heterophile antibodies produced in respons to EBV infection
• Elevated LDH, AST, ALT
• Peripheral smear with lymphocytosis
• Serology (if monospot test is negative)
• Anti-VCA igM, IgG, Anti-EBNA-1 IgG

Question 7

Complications of EBV?

Answer 7

• Guillain- Barre
• Meningoencephalitis
• CN disorder
• Primary CNS lymphoma
• Multiple sclerosis
• Hemophagcytic lymphohistiocytosis,
• Autoimmune hemolytic anemia
• DIC
• HUS
• Splenic rupture
• Oral hairy leukoplakia ( HIV+)
• Pneumonia
• Otitis media
• Hodgkin lymphoma

Question 8

EBV classically characterised by?

Answer 8

• Fever
• Pharyngitis
• lymphadenopathy
• Peripheral blood smear with at least 50% mononuclear cells and 10% atypical lymphocytes

Question 9

Treatment of EBV

Answer 9

Symptomatic treatment
- Avoid physical activity because of risk of splenic rupture
- Fluids if necessary
- Pain management
- Fever management

Question 10

EBV becomes a latent lifelong infection, True or false?

Answer 10

True