Acute infectious mononucleosis

Lymphadenopathy Patients who receive tacrolimus ointment and who develop lymphadenopathy should have the etiology of their lymphadenopathy investigated. In the absence of a clear etiology for the lymphadenopathy, or in the presence of acute infectious mononucleosis, consider discontinuation of tacrolimus ointment. Monitor patients who develop lymphadenopathy to ensure that the lymphadenopathy resolves. 

Atypical acute infectious mononucleosis has been reported in a patient with juvenile ankylosing spondylitis who was treated with infliximab [131 ]. 

A retrospective study of children hospitalised at two tertiary medical centres in Israel with a diagnosis of acute infectious mononucleosis (AIM) secondary to Epstein-Barr virus was conducted to determine the incidence of rash after receipt of various antibiotics. A total of 173 patients were identified as having received antibiotics and 65 did not. Of those who received antibiotics, 57/173 (32.9%) developed a rash compared to 15/65 (23.1%) in the nonantibiotic group. The incidence of rash was significantly higher among patients who had received amoxicillin (29.5%) compared to penicillin, amoxicillin/clavulanate, cephalosporins and macrolides. The authors noted that the incidence of amoxicillin-related rash in children with AIM was lower than the previously reported incidence of rash in children with AIM treated with ampicillin of 90% [32< ]. 

Suggested Alternatives for Differential Diagnosis Adenoviruses, arenaviruses, California encephalitis, coxsackieviruses, cytomegalovirus, dengue fever, eastern equine encephalitis, echoviruses, infectious mononucleosis, Japanese encephalitis, Lyme disease, meningitis, parainfluenza virus, rhinoviruses, bacterial sepsis, severe acute respiratory syndrome (SARS), St Louis encephalitis, upper respiratory infection, Venezuelan encephalitis, and West Nile encephalitis. 

Although infections are generally thought to be particularly frequent and possibly severe in patients treated with steroids, they have been used as short-term adjunctive therapy to reduce the severe symptoms associated with such bacterial infections as acute H. influenzae and miliary tuberculosis and in viral infections, such as hepatitis and infectious mononucleosis. 

The Epstein-Barr viruses play an etiological role in infectious mononucleosis, an acute infections disease that affects lymphoid tissue throughout the body. A strong association of this virus with Burkitf s lymphoma and perhaps nasopharyngeal carcinoma also has been observed. 

The first scientific report of an orally transmitted outbreak of Chagas disease in Brazil was made in 1968 (Nery-Guimaraes et ah, 1968). This occurred in the district of Teutonia, municipality of Estrela (Rio Grande do Sul state) in the year 1965, between March 13 and March 22. Seventeen people from an Agricultural School (workers, students, and lecturers that usually had meals there) fell sick. The initial unconfirmed diagnosis was typhoid fever. Other possible diagnoses like infectious hepatitis, toxoplasmosis, infectious mononucleosis, and food poisoning were also discarded. Then, some of the infected people presented with clinical symptoms of acute myocarditis, and, based on clinical observations,... 

Acute dacryoadenitis usually responds rapidly to systemic corticosteroids. Patients with viral dacryoadenitis associated with acute epidemic parotitis (mumps), infectious mononucleosis, or herpes zoster infection should receive supportive therapy, such as rest, local application of ice, and use of oral analgesics, such as acetaminophen. Supportive therapy for mumps should be continued for its typical 2- to 4-week self-limiting course. 

Infectious hepatitis - acute, 92-95 Infectious mononucleosis, 96-99 Leptospirosis, 114-119... 

In acute hepatitis from toxic agents, such as carbon tetrachloride, there is likewise increased BSP retention (D7, DIO). In infectious mononucleosis, BSP retention is occasionally increased, but flocculation reactions (B18) are abnormal more frequently. 

McKenzie H, Parratt D, White RG (1976) IgM and IgG antibody levels to ampicillin in patients with infectious mononucleosis. Clin Exp Immunol 26 214 Menke HE, Pepplinkhuizer L (1974) Acute nonallergic reaction to aqueous procaine penicillin. Lancet 1 723... 

Previous studies demonstrated the antiviral activity of ascorbate against a broad spectrum of RNA and DNA viruses in vitro (1-4) and in vivo (5, 6). It has been claimed that ascorbate inhibited the activation of a latent human retrovirus (human T-cell leukemia virus 1) induced by 5-iodo-2 -deoxyuridine and JV-methyl-A/ -nitro-A-nitrosoguanidine (7). However, it was not established whether ascorbate exerted a virus-specific effect or interacted directly with the activating substances. In addition, the effects of ascorbate on acute infection by human retroviruses have not been determined. In vivo, oral, and intravenous administration of ascorbate is said to have produced clinical improvements in patients afflicted with influenza, hepatitis, and herpes virus infections, including infectious mononucleosis (5, 6). Clinical improvement was claimed in AIDS patients who voluntarily ingested high doses of ascorbic acid (8). 

Infectious mononucleosis An acute disease that affects many systems, caused by the Epstein-Barr virus. 

Table 1. Comparison of purine enzyme values between normals and patients with infectious mononucleosis or patients with myeloid proliferation including 4 patients with acute myeloid leukemia.

Lund, B. M. and Bergan,T. (1975) Temporary skin reactions to penicillins during the acute stage of infectious mononucleosis. Scand. J. infect. Dis., 7, 21. 

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