Fifteen of 17 (88%) patients presented with clinical/biochemical evidence of jaundice. [scienceopen.com]

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]

If all four are present, there is a 50% chance the cause is bacterial. [almostadoctor.co.uk]

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]

• Hemophilia A

  The vaccine is especially recommended for the following children: Children who live in areas where there has been a community outbreak Children who have a blood clotting disorder, such as hemophilia Children who attend child care centers that have had [stanfordchildrens.org]

  You are at higher risk for hepatitis A if you: Live with or have sex with someone who has hepatitis A Travel to countries where hepatitis A is common Are a man who has sex with other men Use illegal drugs Have a clotting-factor disorder (such as hemophilia [familydoctor.org]

• Splenomegaly

  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]

  The diagnosis of IM was confirmed by the demonstration of high serum titers of antibodies against Epstein-Barr virus, IgM class (4 patients) or heterophil antibodies (1 patient), plus peripheral lymph node enlargement (3 patients), splenomegaly (4 patients [repositorio.uchile.cl]

  The diagnosis is suggested by the presence of a lymphocytosis and/or splenomegaly. The majority of patients do not have infectious mononucleosis. [scienceopen.com]

  An ultrasound study of 19 patients found that in 16 splenomegaly resolved in four weeks but in three it took eight weeks. [patient.info]

  Other symptoms and signs include Splenomegaly Mild hepatomegaly and hepatic percussion tenderness Periorbital edema and palatal petechiae Less frequently maculopapular eruptions Rarely jaundice Splenomegaly, which occurs in about 50% of cases, is maximal [msdmanuals.com]

• Cervical Lymphadenopathy

  there is asymmetrical cervical lymphadenopathy also. [almostadoctor.co.uk]

  He had marked icterus with bilateral cervical lymphadenopathy with generalized pitting edema (Figure 1). Figure 1: He had marked icterus with bilateral cervical lymphadenopathy with generalized pitting edema. There was 5cm hepatomegaly in right MCL. [hepatitis.imedpub.com]

  Splenomegaly (50% of cases), fever, fatigue, malaise Pharyngitis and/or to nsillitis (reddened, enlarged tonsils covered in pus ) ; palatal petechiae Bilateral cervical lymphadenopathy that may become generalized and can, in severe cases, lead to airway [amboss.com]

  Physical examination revealed bilateral cervical lymphadenopathy and hepatosplenomegally. There were no signs of chronic liver disease. His white blood cell count was 15000 per micro liter; with 55% neurophils and 42% lymphocytes. [gastrohep.com]

  Exudative pharyngitis, anterior cervical lymphadenopathy, and fever may be clinically indistinguishable from those caused by group A beta-hemolytic streptococci. [msdmanuals.com]

• Fever

  The fever is a bugger. have a good night. mkh9 [medhelp.org]

  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]

  You can treat the symptoms of fever and pain with pain killers (analgesics) such as acetaminophen (paracetamol) or non-steroidal anti inflammatory drugs such as ibuprofen or aspirin (16+ only). [medinfo.com]

  enlargement of lymph nodes and spleen, lymphocytosis with abnormal lymphocytes similar to monocytes, and heterophil antibody in serum. infectious mononucleosis See GLANDULAR FEVER. glandular fever ; infectious mononucleosis debilitating infectious disease [medical-dictionary.thefreedictionary.com]

  Definition of infectious mononucleosis : an acute infectious disease associated with Epstein-Barr virus that is characterized especially by fever, sore throat, swelling of lymph nodes, fatigue, and lymphocytosis and occurs primarily in adolescents and [merriam-webster.com]

• Fatigue

  For some people, their liver or spleen or both may remain enlarged even after their fatigue ends. Most people get better in two to four weeks; however, some people may feel fatigued for several more weeks. [cdc.gov]

  Infectious mononucleosis is caused by Epstein-Barr virus (EBV, human herpesvirus type 4) and is characterized by fatigue, fever, pharyngitis, and lymphadenopathy. Fatigue may persist weeks or months. [msdmanuals.com]

  Definition of infectious mononucleosis : an acute infectious disease associated with Epstein-Barr virus that is characterized especially by fever, sore throat, swelling of lymph nodes, fatigue, and lymphocytosis and occurs primarily in adolescents and [merriam-webster.com]

  Fatigue is a common complaint among mononucleosis patients. [livescience.com]

  Kradin has a number of clinical interests including Chronic Fatigue Syndrome, Interstitial Lung Disease, Multiple Chemical Sensitivity and Pulmonary Immunology. He also holds an Associate Professor position of Pathology at Harvard Medical School. [books.google.com]

• Pain

  You can treat the symptoms of fever and pain with pain killers (analgesics) such as acetaminophen (paracetamol) or non-steroidal anti inflammatory drugs such as ibuprofen or aspirin (16+ only). [medinfo.com]

  […] urine Loss of appetite Muscle pain Itching Young children are likely to have very mild cases of hepatitis A, while symptoms in older children and adults are more likely to be severe. [familydoctor.org]

  If it becomes severe, your spleen can rupture and cause a sudden, sharp pain on the left side of your upper abdomen. If you have pain like this, it’s an emergency. Get medical care right away because you may need surgery. [webmd.com]

  Treatment usually includes adequate rest and a pain reliever such as acetaminophen (the active ingredient in Tylenol) for your fever, sore throat and other aches and pains. Be sure to increase your fluid intake to avoid dehydration. [lexingtonclinic.com]

  They turn into blisters, become itchy and painful, and then heal. Most people have outbreaks several times a year. Over time, you get them less often. Medicines to help your body fight the virus can help lessen symptoms and decrease outbreaks. [icdlist.com]

• Lymphadenopathy

  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]

  He had marked icterus with bilateral cervical lymphadenopathy with generalized pitting edema (Figure 1). Figure 1: He had marked icterus with bilateral cervical lymphadenopathy with generalized pitting edema. There was 5cm hepatomegaly in right MCL. [hepatitis.imedpub.com]

  Typical manifestations include fatigue (sometimes persisting weeks or months), fever, pharyngitis, splenomegaly, and lymphadenopathy. [msdmanuals.com]

  Lymphadenopathy may also become more generalized, which distinguishes IM from other causes of pharyngitis. Lymphadenopathy peaks in the first week and then gradually subsides over 2 to 3 weeks. [uspharmacist.com]

• Asymptomatic

  Primary EBV infection in children is usually asymptomatic, but in a small number of healthy individuals, typically young adults, EBV infection results in a clinical syndrome of infectious mononucleosis with hepatitis, with typical symptoms of fever, pharyngitis [ncbi.nlm.nih.gov]

  After primary infection, EBV remains within the host, primarily in B lymphocytes, for life and undergoes intermittent asymptomatic shedding from the oropharynx. [msdmanuals.com]

  In both subclinical, and clinical primary infections, the host will carry the virus asymptomatically for the rest of their life, after the initial presentation has resolved. [almostadoctor.co.uk]

  In young children, infections are usually asymptomatic or produce very mild symptoms. [co.monroe.mi.us]

  EBV infection is common world wide and is often asymptomatic with mild self limited hepatitis in 80-90% cases. [hepatitis.imedpub.com]

• Pharyngitis

  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]

  Pharyngitis may be severe, painful, and exudative and may resemble streptococcal pharyngitis. Adenopathy is usually symmetric and may involve any group of nodes, particularly the anterior and posterior cervical chains. [msdmanuals.com]

  A history of sore throat is often accompanied by pharyngeal inflammation and tonsillar oozing, which may appear white, gray-green, or even necrotic. 15 Many patients with acute EBV infection have relatively mild disease, and some present with pharyngitis [uspharmacist.com]

  Pharyngitis Pharyngitis is one of the cardinal manifestations of EBV infectious mononucleosis. Exudative pharyngitis may resemble streptococcal pharyngitis. [emedicine.medscape.com]

• Pneumonia

  Epstein-Barr virus multi-organ attack in a twenty-year-old boy: Myocarditis, pneumonia and hepatitis. Ann Gastroenterol 2003;16:377-80. 3. Busch D, Hilswicht S, Schöb DS, von Trotha KT, Junge K, Gassler N, et al. [jmedsoc.org]

  Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. American J Gastroenterol. 2005;100(2):322-31. [sapd.es]

  Splenomegaly (an enlarged spleen) Joints Arthritis in one or more joints Kidneys Glomerulonephritis Nervous system Meningoencephalitis Bell's palsy (facial palsy) Transverse myelitis Guillain–Barré syndrome Gastrointestinal tract Hepatitis Lungs Interstitial pneumonia [dermnetnz.org]

  He also ordered a chest x-ray to rule out pneumonia although her lungs sounded clear. At this point, he thinks she has a bad case of mono (she lost 3 pounds in 2 weeks too). [medhelp.org]

  In bone marrow recipients, CMV infection occurs as an interstitial pneumonia with high mortality. In liver recipients, hepatitis can be problematic and may be difficult to discern from organ rejection. [aafp.org]

• Common Cold

  It’s contagious, but you’re less likely to catch mono than other illnesses like the common cold. Mono isn’t usually a serious illness, but it can lead to complications that in some cases make the disease more dangerous. [webmd.com]

  It's not nearly as contagious as the common cold. However, the virus can persist in the throat of an infected person for a long time. [medbroadcast.com]

  "The good news is mono isn't as contagious as the common cold," Dr. Sampson Davis, a physician at St. Michaels Medical Center in Newark, New Jersey, told Live Science. [livescience.com]

  Remember that many children and healthy adults will not experience any symptoms, or the symptoms may seem like a normal childhood illness or the common cold. [americanpregnancy.org]

  Having a sore throat can be a symptom of many conditions, and many people wonder if their own sore throat might be a sign of something more serious than the common cold. [medicinenet.com]

• Loss of Appetite

  You could develop a fever, fatigue, sore throat, swollen lymph nodes, or other symptoms, like sore muscles and a loss of appetite. Mono can cause different combinations of symptoms in different people. [webmd.com]

  […] of appetite Muscle pain Itching Young children are likely to have very mild cases of hepatitis A, while symptoms in older children and adults are more likely to be severe. [familydoctor.org]

  A 21-year-old mole was admitted because of fever, fatigue, headache, pharyngitis, abdominal pain, loss of appetite, vomiting and dark urine for three days. The patient denied recent use of medicines or any other drug. [scienceopen.com]

  Other very common symptoms as hepatitis progress are fatigue, muscle and joint aches, and loss of appetite. There are many more symptoms of hepatitis which are less common but no less important. [verywell.com]

  Early symptoms can include feeling rundown, loss of appetite and slight headaches. [lexingtonclinic.com]

• Jaundice

  Fifteen of 17 (88%) patients presented with clinical/biochemical evidence of jaundice. [scienceopen.com]

  Infectious mononucleosis due to Epstein-Barr virus (EBV) infection sometimes causes acute hepatitis, which is usually self-limiting with mildly elevated transaminases, but rarely with jaundice. [ncbi.nlm.nih.gov]

  In approximately 5% of all cases, mild jaundice was noted, which may result from haemolysis or cholestasis.( 1 ) Jaundice is seen less frequently in children than adults.( 5 ) After the second week, our patient developed clinical jaundice and conjugated [smj.org.sg]

  Other: unknown, not jaundiced. Table 1. [onlinelibrary.wiley.com]

  Serum aminotransferases were moderately raised in all patients; three patients had mild jaundice with a direct-reacting hyperbilirubinemia; 4 patients had an enlarged and tender liver. [repositorio.uchile.cl]

• Hepatomegaly

  […] mononucleosis with polyneuropathy Gammaherpesviral mononucleosis Gammaherpesviral mononucleosis with meningitis Gammaherpesviral mononucleosis with polyneuropathy Hepatomegaly due to cytomegalovirus mononucleosis Hepatomegaly due to gamma herpes mononucleosis [icd9data.com]

  At presentation, she had tender hepatomegaly with a markedly deranged liver function test. Abdominal ultrasonography showed hepatomegaly and a thickened gallbladder wall. [smj.org.sg]

  Up to 90% of patients also have a mild hepatitis Splenomegaly occurs in 50% of patients Jaundice and hepatomegaly are rare Occasionally patients may present with hepatitis with none of the other features It can be difficult to differentiate from other [almostadoctor.co.uk]

  Clinically, fever, splenomegaly, hepatomegaly, lymphadenopathy, maculopapular rash, and neurological signs occur in decreasing order of frequency. The patient in discussion had most of these clinical manifestations. [jmedsoc.org]

  […] fatigue, malaise Pharyngitis and/or to nsillitis (reddened, enlarged tonsils covered in pus ) ; palatal petechiae Bilateral cervical lymphadenopathy that may become generalized and can, in severe cases, lead to airway obstruction Abdominal pain Possibly hepatomegaly [amboss.com]

• Skin Rash

  A 26-year-old woman who presented with fever, generalized weakness, nausea, sore throat, yellowing of skin, and a generalized skin rash was admitted to our clinic. [jidc.org]

  Symptoms of an EBV infection may include: Fever Sore throat Exhaustion Skin rash Swollen neck lymph nodes Enlarged liver and spleen These symptoms should only last as long as any other common illness, typically no longer than 1-2 weeks. [americanpregnancy.org]

  You can also get a strep throat infection, low platelet count, skin rash, and enlarged spleen. The enlarged spleen is more common than enlarged liver. [medhelp.org]

  A small percentage of people may experience jaundice (a yellowing of the skin) caused by the breakdown of red blood cells or liver problems. Some may develop a skin rash. [medbroadcast.com]

• Myalgia

  Arthralgias and myalgias occur but are less common than in other viral infectious diseases and are rarely severe. Other symptoms include cough, chest pain and photophobia. [patient.info]

  Table 1 Initial liver function tests Bilirubin 37 umol/L 6–24 GGT 466 U/L 0–60 ALP 342 U/L 30–110 ALT 728 U/L 0–55 AST 460 U/L 0–45 A repeat examination the following day revealed marked icterus in addition to generalized abdominal discomfort and myalgia [jmedicalcasereports.biomedcentral.com]

  Clinical features and outcome from 17 cases of EBV hepatitis 1 Yes Yes Yes No Yes LUQ Diarrhoea No 26 6 No Yes 2 Yes Yes Yes No No Myalgia, vomiting, lethargy No N/A N/A Yes Yes 3 Yes Yes No No Yes RUQ Fatigue, weight loss, anorexia No 4 8 No Yes 4 Yes [onlinelibrary.wiley.com]

  The presentation of “CMV syndrome” (consisting of fever, leukopenia, atypical lymphocytes, hepatomegaly, myalgia, and arthralgia) is the most common manifestation of primary CMV in kidney transplant patients. 26 The Author show all author info GREGORY [aafp.org]

Infectious Mononucleosis Workup. Medscape. Available online at http://emedicine.medscape.com/article/222040-workup. Accessed June 13, 2016. (Aug 2004) Hess, R. [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]

• Human Herpesvirus 6

  (EBV = Epstein Barr virus; HIV = human immunodeficiency virus; CMV = cytomegalovirus.) *--Use branched-chain DNA to detect non-B subtype HIV. †--Human herpesvirus 6 diagnosis by fourfold rise in titer or plasma DNA. [aafp.org]

  A growing number of pathogens have been associated with heterophile-negative mononucleosis-like illnesses - eg, CMV, rubella, human herpesvirus 6, HIV infection, adenovirus, herpes simplex virus, Streptococcus pyogenes and Toxoplasma gondii. [patient.info]

  Breast milk is not a significant source for early Epstein-Barr virus or human herpesvirus 6 infection in infants: a seroepidemiologic study in 2 endemic areas of human T-cell lymphotropic virus type I in Japan. [uspharmacist.com]

  herpesvirus 6 (HHV-6), acute HIV disease, toxoplasmosis, and anicteric viral hepatitis. [emedicine.medscape.com]

Treatment is usually conservative although there has been significant debate over the role of oral corticosteroids, especially in more serious cases. [casereports.bmj.com]

Current management of pyogenic liver abscess: surgery is now secondline treatment. J Am Coll Surg. 2010; 210(6):975-83. Cai YL, Xiong XZ, Lu J, Cheng Y, Yang C, Lin YX, et al. [sapd.es]

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]

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]

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]

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]

Pyogenic liver abscess: recent trends in etiology and mortality. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2004;39(11):1654-9. Lederman ER, Crum NF. [sapd.es]

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]

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]

Some studies indicate that a person can spread the infection for many months, possibly up to a year and a half. [31] Pathophysiology [ edit ] The virus replicates first within epithelial cells in the pharynx (which causes pharyngitis, or sore throat), [en.wikipedia.org]

Raised awareness of this changing pattern of disease could prevent unnecessary investigation and consequent potential iatrogenic complications. [ncbi.nlm.nih.gov]

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]

[…] 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]

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]