EBV Infections

Question 1

What condition which commonly affects teenagers/young adults is caused by EBV virus?

Answer 1

Infectious Mononucleosis (glandular fever).

EBV secreted in saliva of infected individuals, can be infectious for several weeks before symptoms occur.

Most ppl are infected with EBV as children when it causes fewer symptoms.

Question 2

Clinical features of infectious mononucleosis?

Answer 2

Fever, sore throat, fatigue, lymphadenopathy
Tonsillar enlargement,
palatal petechai
Splenomegaly in rare cases splenic rupture.

Self limiting, lasts 2-4 weeks

Common in ages 15-24

Question 3

What does amoxicillin do when given to individuals with mono?

Answer 3

Causes an itchy widespread maculopapular rash-

mononucleosis causes an intesnly itchy rash in response to amoxicillin or cefalosporins.

Question 4

Investigations for infectious mononucleosis?

Answer 4

If immunocompromised arrange viral serology test after person has been ill for >7 days.

In >12 yrs and immunocompetent:
FBC in 2nd week of illness (shows raised lymphocyte count)

Question 5

What tests are specific for infectious mononucleosis?

Answer 5

Monospot test
Paul-Bunnell test.

In IM, the body produces heterophile antibodies which are antibodies that are multipurpose and not specific to EBV antigens. It can take up to 6 weeks for these antibodies to be produced.

EBV specific antibodies:
IgM: rises early, suggest acute infection
IgG: persists after condition and suggests immunity.

Question 6

Management for infectious mon?onucleosis

Answer 6

Acute illness lasts 2-3 weeks and is self limiting, but can leave patient fatigued for months afterwards.

Advise to avoid alcohol (EBV impacts ability of liver to process alcohol).
Avoid contact sports due to risk of splenic rupture.

Question 7

Complications of infectious mononucleosis?

Answer 7

Splenic rupture
Glomerulonephritis
Haemolytic anaemia
Thrombocytopenia
Chronic fatigue