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Infectious Mononucleosis Hepatitis


Presentation

  • Both cases involved young adults presenting with fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, and atypical lymphocytosis confirmed by serologic tests, liver biopsy and electron microscopic study.[ncbi.nlm.nih.gov]
  • This book presents the facts as they are known today and, in areas where all the facts are not established, presents the well-founded opinions of those considered to be authorities.[books.google.com]
  • We present a case of a fit and well man who had significant multi-organ involvement secondary to infectious mononucleosis, and our experience of oral corticosteroid treatment.[casereports.bmj.com]
  • The present study indicates that infectious mononucleosis is not so rare in Japan and sometimes complicates with severe hepatitis.[jstage.jst.go.jp]
  • The amount of residual virus present on the red cell after adsorption and elution, the hemagglutinin titer against chicken and human red cells, and the infectivity titer for eggs were all closely comparable for these virus strains as well as for 2 other[jimmunol.org]
Malaise
  • Symptomatic individuals typically first experience fever, malaise, and fatigue, which is later accompanied by acute pharyngitis, tonsillitis, lymphadenopathy, and/or splenomegaly lasting up to a month.[amboss.com]
  • Any combination of the following may be present: Headache Fever Tonsillitis / sore throat Cervical lymph node enlargement and tenderness (usually symmetrical) Malaise and severe fatigue May have tonsillar exudate Nausea / vomiting / GI symptoms.[almostadoctor.co.uk]
  • Fatigue and general malaise may persist for months after infection clears.[medical-dictionary.thefreedictionary.com]
  • Fatigue and malaise may persist for several months after the acute infection has resolved. [ 6 ] Sore throat; tonsillar enlargement is common, classically exudative and may be massive; palatal petechiae and uvular oedema.[patient.info]
  • Five to 7 percent of immunocompetent patients with this syndrome who present to a physician's office will have acute CMV infection. 6 CMV-induced mononucleosis can be symptomatically indistinguishable from EBV-induced mononucleosis. 7 Malaise, fever up[aafp.org]
Pathologist
  • Kradin is also an Associate Pathologist at Massachusetts General Hospital in the Immunopathology Unit. His techniques include tissue culture and immunocytochemistry, flow cytometry, Northern blotting and immunocytochemistry. Dr.[books.google.com]
Fishing
  • Wash fruits and vegetables thoroughly before eating and avoid raw or undercooked meat and fish.[familydoctor.org]
Military Personnel
  • Surgery is usually advocated for spontaneous splenic rupture but non-operative management may be appropriate. [ 5 ] One study of military personnel suggested a role for vitamin D in shortening recovery times in patients with acute pharyngitis associated[patient.info]
Dark Urine
  • The dark urine is mostly from the liver. But I'm worried about how high her fever is. Be sure to tell the doctor how high the fever got. I 'm sure you will but that is important. Yes the symptoms of mono do last a long time.[medhelp.org]
  • urine Later symptoms include dark-colored urine and jaundice (yellowing of the skin, and eyes).[stanfordchildrens.org]
Lethargy
  • Symptoms can vary from sore throat, enlarged lymph glands, lethargy and weight loss to more serious clinical manifestations such as myocarditis or hepatitis.[casereports.bmj.com]
  • Yes Yes No Yes LUQ Anorexia, flu like illness a No 6 8 No No 5 Yes Yes Yes Yes Yes Flu like illness, lymphadenopahy No 4 8 b No Yes 6 No Yes Yes Yes No Lymphadenopathy No 3 5 No Yes 7 Yes No Yes Yes No Anorexia, lethargy Lymphadenopathy No 4 4 No Yes[onlinelibrary.wiley.com]
  • However, symptoms returned on Day 16 with low-grade fever, extreme lethargy, poor appetite, weight loss and jaundice. The patient’s LFT showed markedly raised transaminases and conjugated hyperbilirubinaemia ( Fig. 2a & b).[smj.org.sg]
Myelopathy
  • […] ulcerative lesions. 9 Patients with HIV who have low CD4 counts may experience complications from CMV involvement of the esophagus, colon, mucous membranes (ulcerative lesions and colitis), brain (meningoencephalitis), peripheral nerves (radiculopathy and myelopathy[aafp.org]

Workup

  • Infectious Mononucleosis Workup. Medscape. Available online at . Accessed June 13, 2016. (Aug 2004) Hess, R. Routine Epstein-Barr Virus Diagnostics from the Laboratory Perspective: Still Challenging after 35 Years. Journal of Clinical Microbiology.[labtestsonline.it]
  • In view of the significant transaminitis, diagnostic workup was performed for other causes of hepatitis. Extended screening investigations were negative for autoimmune hepatitis, Wilson’s disease and haemophagocytic lymphohistiocytosis (HLH).[smj.org.sg]
Liver Biopsy
  • Both cases involved young adults presenting with fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, and atypical lymphocytosis confirmed by serologic tests, liver biopsy and electron microscopic study.[ncbi.nlm.nih.gov]
  • References 182 Hepatitis B 192 Toxic And DrugInduced Hepatitis 201 References 214 Chronic Persistent Hepatitis 224 References 226 Genetic Background 236 References 242 Chronic Active Hepatitis 248 Role of the Liver Biopsy in Differential Diagnosis 255[books.google.com]
  • Since inflammation of the liver can lead to bleeding problems, a liver biopsy is not usually done unless the origin of hepatitis cannot be found based on other tests.[verywell.com]
  • Liver biopsy could not be done as coagulation profile was abnormal and remained so even after giving vitamin K and FFP. But even after all the measures taken, he gradually deteriorated, liver function further worsened.[hepatitis.imedpub.com]

Treatment

  • Treatment is usually conservative although there has been significant debate over the role of oral corticosteroids, especially in more serious cases.[casereports.bmj.com]
  • […] may involved the medulla of the brain represents the highest mortality rate of any human disease is associated with the Epstein-Barr virus affects the nerve tissues of the spinal cord and brain is caused by a virus resistant to physical and chemical treatment[quizlet.com]
  • Acyclovir and prednisolone treatment of acute infectious mononucleosis: a multicenter, double-blind, placebo-controlled study. J Infect Dis 1996; 174 (2): 324–31 .[gastrohep.com]
  • Mild hepatitis, which usually goes away on its own without treatment. Other complications of mono can occur but are very rare. These include: A ruptured spleen.[uwhealth.org]

Prognosis

  • Hepatitis and Chronic Lobular Hepatitis 259 References 265 Associated Autoimmune Disorders 273 References 279 Idiopathic Hepatitis versus Chronic Cholestatic Disease 288 Diagnostic Approach 297 Management 307 Hepatitis B Chronic Active Hepatitis 313 Prognosis[books.google.com]
  • The exact reason of encephalopathy is very difficult to make out but whatever may be the reason, it carries a poor prognosis.[hepatitis.imedpub.com]
  • Although the prognosis for IM is very favorable, a variety of acute complications may occur. How to Cite 1. Uluğ M, Çelen M, Ayaz C, Geyik M, Hoşoğlu S (2010) Acute hepatitis: a rare complication of Epstein-Barr virus (EBV) infection.[jidc.org]
  • Prognosis Usually asymptomatic or of short duration and self-limiting.[patient.info]

Etiology

  • EBV is rather uncommonly confirmed as an etiologic agent of acute hepatitis in adults.[ncbi.nlm.nih.gov]
  • IMPORTANT POINTS The etiologic agent for infectious mononucleosis is Epstein-Barr virus, although a mononucleosis-like syndrome can be caused by other viral agents, most notably cytomegalovirus.[pedsinreview.aappublications.org]
  • Etiology Pathogen : Epstein-Barr virus ( EBV ), also called h uman herpes virus 4 ( HHV-4 ) Transmission : Infectious mononucleosis is highly contagious and spreads via bodily secretions, especially saliva ; " kissing disease " References: [1] Pathophysiology[amboss.com]
  • The presence of intranuclear inclusion bodies and intense positive staining of hemophagocytic cells for LMP-1 provided the final clue to the etiological diagnosis of EBV that had led to hemophagocytic lymphohistiocytosis.[jmedsoc.org]

Epidemiology

  • We discuss the importance of differing clinical manifestations in older and younger age groups, the changing epidemiology of Epstein Barr (EB) infection within the United Kingdom and the role of different virology tests in establishing a diagnosis.[ncbi.nlm.nih.gov]
  • Footnotes 1 This investigation was aided by the Commission on Virus and Rickettsial Diseases, Armed Forces Epidemiological Board, Washington, D.[jimmunol.org]
  • Epidemiology Approx. 90–95% of adults are EBV -seropositive worldwide. Peak incidence : of symptomatic disease: 15–24 years Incidence : 500/100,000 per year in the US References: [1] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Epidemiology EBV preferentially infects B lymphocytes and is transmitted primarily in saliva or, less commonly, by blood transfusion. It is not likely to be transmitted by aerosol or fomites.[pedsinreview.aappublications.org]
  • Epidemiology Up to 95% of individuals carry the virus Approximately 50% of cases are symptomatic on primary infection, most commonly in the form of Infectious Mononucleosis Can present at any age.[almostadoctor.co.uk]
Sex distribution
Age distribution

Pathophysiology

  • Etiology Pathogen : Epstein-Barr virus ( EBV ), also called h uman herpes virus 4 ( HHV-4 ) Transmission : Infectious mononucleosis is highly contagious and spreads via bodily secretions, especially saliva ; " kissing disease " References: [1] Pathophysiology[amboss.com]

Prevention

  • Raised awareness of this changing pattern of disease could prevent unnecessary investigation and consequent potential iatrogenic complications.[ncbi.nlm.nih.gov]
  • […] tissues of the spinal cord and brain is caused by a virus resistant to physical and chemical treatment has an incubation period that varies from 6 days to one year is caused by a type of herpes virus vaccination is possible after exposure to the virus prevention[quizlet.com]
  • Centers for Disease Control and Prevention (CDC), at least 80,000 people in the United States are infected with HBV each year, and about 5,000 die from the disease annually.[humanillnesses.com]
  • Can You Prevent It? There’s no vaccine to prevent mono. EBV can stay in your saliva for months after you’re infected, so even if you don’t have symptoms or feel sick, you may be able to spread it. This makes it hard to prevent the spread of mono.[webmd.com]
  • Is it possible to prevent mono? Since mono is spread from person to person, avoiding close personal contact with infected individuals and practicing excellent hygienic practices can help prevent transmission of the virus.[medicinenet.com]

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