ID - Infectious Mononucleosis Flashcards
What is infectious mononucleosis also known as?
Glandular fever
What causes IM?
Epstein Barr virus
How is IM spread?
Virus present in saliva
Infection spread by kissing, sharing cups, toothbrushes etc.
When are most people infected with EBV?
As children, causes very symptoms
If it occurs in teenagers or young adults can cause symptomatic infection
How does IM present?
Fever
Sore throat
Fatigue
What are the features of IM?
Fever
Sore throat
Fatigue
Lymphadenopathy
Enlarged tonsils
Splenomegaly - rarely leads to splenic rupture
What are heterophile antibodies?
Multipurpose antibodies that are not specific to a singular virus antigen
How can heterophile antibodies be tested for in EBV?
Monospot test
Patient’s blood introduced to horse RBCs, if present heterophile antibodies will react to horse RBCs
Paul-Bunnell test
Uses RBCs from sheep instead
Comment on the specificity and sensitivity of the heterophile tests for EBV
Almost 100% specific for IM
Not everyone who has IM produces heterophile antibodies, can take up to 6 weeks
70-80% sensitive
What do EBV specific antibodies target?
Viral capsid antigen (VCA)
When are the IgM and IgG antibodies present in EBV?
IgM
Rises early and suggests acute infection
IgG
Persists after condition and suggests immunity
How long does IM typically last?
2-3 weeks
Can leave patient with fatigue for several months once infection is cleared
What must be avoided in EBV?
Alcohol
Contact sports - splenic rupture, will need emergency surgery if rupture occurs
Why must alcohol be avoided in EBV?
EBV affects liver’s ability to process alcohol
What are the complications of EBV?
Splenic rupture
Glomerulonephritis
Haemolytic anaemia
Thrombocytopenia
Chronic fatigue
