Acute complications of Epstein-Barr virus infectious mononucleosis

Abstract

Infectious mononucleosis caused by Epstein-Barr virus (EBV) usually resolves over a period of weeks or months without sequelae but may occasionally be complicated by a wide variety of neurologic, hematologic, hepatic, respiratory, and psychological complications. The strength of association of EBV with many of these complications remains based on scattered case reports, often using unsophisticated diagnostic tests, and the evidence for causation in many instances is unconvincing. There is little benefit of antiviral treatment of uncomplicated or complicated infectious mononucleosis. Corticosteroids may have a role in hastening resolution of some complications, especially upper airway obstruction and possibly immune-mediated anemia and thrombocytopenia, but should be used judiciously.

Evasion of affinity-based selection in germinal centers by Epstein–Barr virus LMP2A

“…S7), which often is associated with autoantibody production in murine autoimmunity models (31,48). Likewise, autoantibody production often is observed in IM patients (49,50). We speculate that LMP2A may have an important role in the generation of selfreactive B cells by enabling EBV-infected B cells to bypass GC selection.…”

Acute Acalculous Cholecystitis Complicating the Course of Infectious Mononucleosis

“…Mild transient elevation in serum aminotransferases is commonly reported and mild jaundice is reported in 5% of cases possibly as a result of cholestasis or virus-induced hemolysis (14).…”

“…The mean duration of Infectious Mononucleosis is 16 days, which is much longer than the duration of most acute viral illnesses, recovery is gradual and it may take months for the patient to feel well (20).Complications may be due to virus invasion of the tissues or immune-mediated damage. Many complications are associated with EBV most of them are uncommon or rare: airway obstruction, meningoencephalitis, hemolytic anemia, thrombocytopenia, splenic rupture, other neurologic disease, psychological disorders (2,10,14,21,29). EBV has oncogenic properties,it is associated with lymphoproliferative disorders and neoplastic disease, including Burkitt's lymphoma and nasopharyngeal carcinoma.…”

Epstein-Barr Virus Infectious Mononucleosis in a Splenectomized Patient

“…Common laboratory findings in patients with IM include marked lymphocytosis with atypical lymphocytes [2]. Additionally, elevation of aminotransferase levels often occurs in 50-80% of patients with IM [3], especially in older children and adults. Epstein-Barr virus (EBV) is most commonly associated with IM, while other viruses, such as cytomegalovirus (CMV), human immunodeficiency virus (HIV), and human herpesvirus 6, can also cause IM [4].…”