Mononucleosis

Lymph nodes, epitrochlear - enlarged [7] Lymph nodes, gen - enlarged [5] 

Spleen - enlarged (splenomegaly) [6, 11] Spleen - tender [11] A Temperature, body - elevated (fever) 

Throat - exudate Throat - injected Throat - sore 

Includes, but not limited to Lymphocytic leukemia Other forms of hepatitis Streptococcal pharyngitis 

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Lymphocyte 20-40% T cells (cell-mediated immunity) B cells (humoral antibody response) Lymphocytosis Viral infections (e.g., mononucleosis) Tuberculosis Fungal infections Lymphopenia human immunodeficiency virus... 

GVL Graft-versus-leukemia IM Intramuscular infectious mononucleosis... 

Dysmotility has been reported in Lyme disease [166] and in postviral syndromes associated with cytomegalovirus and herpes simplex virus [167], Altered intestinal motility can also be part of infectious mononucleosis [168]. 

VassalloM, Camilleri M, Caron BL, Low PA Gastrointestinal motor dysfunction in acquired selective cholinergic dysautonomia associated with infectious mononucleosis. Gastroenterology 1991 100 252-258. 

Immunocytochemical methods were developed to detect specific antibodies in sera from patients affected by different infectious diseases. P3-HR1 cells, which express Epstein-Barr-virus-induced virus capsid antigens (VCA), were used to search for specific human IgM (class M immunoglobulins) to VCA in infectious mononucleosis patients. After treatment of cells with serial dilutions of sera, HRP-conjugated anti-IgM antibody was added and detected with CL substrate [25],... 

Suggested Alternatives for Differential Diagnosis Influenza, infectious mononucleosis, hepatitis, leptospirosis, infective endocarditis, malaria, tuberculosis, typhoid fever, cryptococcosis, histoplasmosis, ankylosing spondylitis and undifferentiated spondyloarthropathy, collagen vascular disease, chronic fatigue syndrome, malignancy, and osteomyelitis. 

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. 

Suggested Alternatives for Differential Diagnosis Dengue, measles, Rocky Mountain spotted fever, rubella, tick bite fever, epidemic typhus, Q fever, typhoid, malaria, trypanosomiasis, hepatitis, infectious mononucleosis, herpes, and influenza. 

Suggested Alternatives for Differential Diagnosis Anthrax, brucellosis, dengue, ehrlichiosis, infectious mononucleosis, Kawasaki disease, leptospirosis, malaria, meningitis, men-ingococcemia, relapsing fever, Rocky Mountain spotted fever, syphilis, toxic shock syndrome, toxoplasmosis, tularemia, typhoid fever, rubella, measles. 

Clinical presentations of primary HIV infection vary, but patients often have a viral syndrome or mononucleosis-like illness with fever, pharyngitis, and adenopathy (Table 40-3). Symptoms may last for 2 weeks. 

Anhaptoglobinemia or subnormal Hp values, often found in acute and chronic liver disease, and in mononucleosis, may also be caused by an increased consumption and not by decreased synthesis. In both disorders there exists a tendency for the development of splenomegaly, i.e., a tendency to retarded splenic blood flow with slightly shortened survival time of the red cells as a consequence. If we do not presume a half-life of Hp in normals below one day, the main part of the Hp catabolism must be secondary to Hb release. Hence, subnormal Hp values will probably appear in conditions with no clinically observable increased hemolysis or slightly decreased Hp synthesis. The latter may be a con-... 

The most common early illness seen with HIV infection resembles another viral disease, mononucleosis. Mononucleosis is not exclusive to a particular virus. The most prominent symptoms are swollen lymph glands, which in case of HIV include lymph glands throughout the body (generalized lymphadenopathy). There may be also a sore throat, a fever, and a skin rash. 

Infectious diseases AIDS/HIV Hepatitis Influenza Mononucleosis Syphilis... 

Common childhood vaccines include the three-in-one measles, mumps and rubella and the diphtheria vaccine. Infectious mononucleosis, also knov/n as glandular fever, is caused by the Epstein-Barr virus and no vaccine is available. 

A viral etiology has been implicated in Burkitt s lymphoma, and there is some evidence that Epstein-Barr virus causes infectious mononucleosis in Europe and Burkitt s lymphoma in Africa. It has been suggested that if the cause of the Burkitt s lymphoma is viral, then entry of the virus particles into the lymphoid colls of the body may derange a part of the cell immune process, subsequently affecting the production of the IgM antibody, a theory which is compatible to the dysproteinemia sometimes seen in multiple myeloma and other lymphomas (N2). Also in support of this is the observation that C-reactive protein was markedly elevated in the serum of patients with Burkitt s lymphoma, and disappeared entirely from the blood when they were cured (MIO). The relationship between malarial infection and Burkitt s lymphoma has been dealt with in a previous section on malaria. 

Hypersensitivity Fever, skin eruptions of various types, including exfoliative dermatitis, infectious mononucleosis-like, or lymphoma-like syndrome, leukopenia, agranulocytosis, thrombocytopenia, Coombs positive hemolytic anemia, jaundice, hepatitis, pericarditis, hypoglycemia, optic neuritis, encephalopathy, Leoffler s syndrome, vasculitis, and a reduction in prothrombin. 

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. 

Acute otitis media (AOM) in children is mostly caused by pneumococci and H. influenzae. It should be differentiated from otitis media with effusion (OME) in which there are no symptoms of acute infection. Furuncles of the nose are caused by S. aureus. It has to be differentiated from diphteria (in unvaccinated children) caused by Corynebac-terium diphteriae and from mononucleosis infec-tiosa caused by Epstein-Barr virus. Chronic ear infections are caused by S. aureus and gram-negative bacillae. Malignant otitis externa in diabetics is caused by P. aeruginosa. 

The incidence of nonallergic ampicillin eruptions is 40 to 100% in patients with concomitant Epstein-Barr virus (mononucleosis), cytomegalovirus, acute lymphocytic leukemia, lymphoma, or reticulosarcoma. Nonallergic penicillin-associated rashes are characteristically morbilliform (symmetrical, erythematous, confluent, maculopapular) eruptions on the extremities. The onset of typical nonallergic eruptions is more than 72 hours after (3-lactam exposure. The mechanism for the nonurticarial ampicillin rash is not known and is not related to IgE or type I hypersensitivity. Penicillin skin tests are not useful in the evaluation of nonurticarial ampicillin rashes. Patients with a history of nonurticarial ampicillin rashes may receive other (3-lactam antibiotics without greater risk of subsequent serious allergic reactions. 

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. 

B virus have been reported in cases of infectious mononucleosis. 

Unlabeled Uses Oral, parenteral Prophylaxis of herpes simplex and herpes zoster infections, infectious mononucleosis. 

High rates of rash in patients on allopurinol, with mononucleosis, or lymphocytic leukemia... 

Infectious mononucleosis. sesses antimalarial activity similar to that... 

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