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Surgical Pathology Clinics Sep 2019Although about 90% of the world's population is infected by EBV only a small subset of the related infections result in neoplastic transformation. EBV is a versatile... (Review)
Review
Although about 90% of the world's population is infected by EBV only a small subset of the related infections result in neoplastic transformation. EBV is a versatile oncogenic agent involved in a multitude of hematopoietic, epithelial, and mesenchymal neoplasms, but the precise role of EBV in the pathogenesis of many of the associated lymphoid/histiocytic proliferations remains hypothetical or not completely understood. Additional studies and use of evolving technologies such as high-throughput next-generation sequencing may help address this knowledge gap and may lead to enhanced diagnostic assessment and the development of potential therapeutic interventions.
Topics: Animals; Chronic Disease; Culicidae; Diagnosis, Differential; Epstein-Barr Virus Infections; Humans; Hydroa Vacciniforme; Immunosuppressive Agents; Infectious Mononucleosis; Insect Bites and Stings; Lymphoma, B-Cell; Lymphoma, T-Cell; Lymphomatoid Granulomatosis; Lymphoproliferative Disorders; Neoplasms, Plasma Cell; Prognosis; Pseudolymphoma; Virus Latency
PubMed: 31352986
DOI: 10.1016/j.path.2019.03.002 -
Journal of Medical Virology Nov 2023The human genome is organized in an extremely complexed yet ordered way within the nucleus. Genome organization plays a critical role in the regulation of gene... (Review)
Review
The human genome is organized in an extremely complexed yet ordered way within the nucleus. Genome organization plays a critical role in the regulation of gene expression. Viruses manipulate the host machinery to influence host genome organization to favor their survival and promote disease development. Epstein-Barr virus (EBV) is a common human virus, whose infection is associated with various diseases, including infectious mononucleosis, cancer, and autoimmune disorders. This review summarizes our current knowledge of how EBV uses different strategies to control the cellular 3D genome organization to affect cell gene expression to transform normal cells into lymphoblasts.
Topics: Humans; Herpesvirus 4, Human; Epstein-Barr Virus Infections; B-Lymphocytes; Infectious Mononucleosis
PubMed: 37988227
DOI: 10.1002/jmv.29234 -
Multiple Sclerosis (Houndmills,... Apr 2024
Topics: Humans; Infectious Mononucleosis; Multiple Sclerosis; Risk Factors
PubMed: 38511833
DOI: 10.1177/13524585241237708 -
South Dakota Medicine : the Journal of... Mar 2015In the primary care clinic, allowing young athletes to return to play following injuries and illnesses can be a challenging balancing act between promoting speed of... (Review)
Review
BACKGROUND
In the primary care clinic, allowing young athletes to return to play following injuries and illnesses can be a challenging balancing act between promoting speed of recovery while still allowing for full recovery and prevention of future injuries or complications.
METHODS
A literature review of relevant return-to-play articles was performed for musculoskeletal injuries, concussions, and infectious mononucleosis.
RESULTS
We identified several evidence-based approaches to allowing athletes to return to activity following injuries and illnesses. The majority of return-to-play recommendations found were expert opinion-based.
DISCUSSION
Evidence does exist for primary care providers to assist in guiding their athletic patients back to activity, but it is limited in quantity and quality. The decision to return-to-play is complex, and is best individualized for the patient. Existing guidelines can assist in management; however, only as an adjunct to the clinical decision of a well-informed physician practicing patient-centered medical care.
Topics: Athletic Injuries; Brain Concussion; Humans; Infectious Mononucleosis; Musculoskeletal System; Practice Guidelines as Topic; Primary Health Care; Sports
PubMed: 25906501
DOI: No ID Found -
JAMA Apr 2016Early, accurate diagnosis of infectious mononucleosis can help clinicians target treatment, avoid antibiotics, and provide an accurate prognosis. (Review)
Review
IMPORTANCE
Early, accurate diagnosis of infectious mononucleosis can help clinicians target treatment, avoid antibiotics, and provide an accurate prognosis.
OBJECTIVE
To systematically review the literature regarding the value of the clinical examination and white blood cell count for the diagnosis of mononucleosis.
DATA SOURCES
The databases of PubMed (from 1966-2016) and EMBASE (from 1947-2015) were searched and a total of 670 articles and abstracts were reviewed for eligibility.
STUDY SELECTION
Eleven studies were included that reported data sufficient to calculate sensitivity, specificity, or both for clinical examination findings and white blood cell count parameters compared with a valid reference standard.
DATA EXTRACTION AND SYNTHESIS
Data were abstracted from each article by at least 2 reviewers, with discrepancies reconciled by consensus. Clinical findings evaluated in only 1 study are reported with sensitivity, specificity, likelihood ratio (LR), and 95% confidence interval, which were calculated from the available data. Findings evaluated in only 2 studies were summarized with their range, findings evaluated in 3 studies were summarized with a univariate random-effects summary, and findings evaluated in 4 or more studies were summarized with a bivariate random-effects meta-analysis.
MAIN OUTCOMES AND MEASURES
Sensitivity, specificity, and LRs for the diagnosis of mononucleosis.
RESULTS
Mononucleosis is most commonly present among patients aged 5 to 25 years (especially those aged 16-20 years, among whom approximately 1 in 13 patients presenting with sore throat has mononucleosis). The likelihood of mononucleosis is reduced with the absence of any lymphadenopathy (summary sensitivity, 0.91; positive LR range, 0.23-0.44), whereas the likelihood increases with the presence of posterior cervical adenopathy (summary specificity, 0.87; positive LR, 3.1 [95% CI, 1.6-5.9]), inguinal or axillary adenopathy (specificity range, 0.82-0.91; positive LR range, 3.0-3.1), palatine petechiae (specificity, 0.95; positive LR, 5.3 [95% CI, 2.1-13]), and splenomegaly (specificity range, 0.71-0.99; positive LR range, 1.9-6.6). Symptoms are of limited value for the diagnosis of mononucleosis; sore throat and fatigue are sensitive (range, 0.81-0.83) but nonspecific. The presence of atypical lymphocytosis significantly increases the likelihood of mononucleosis (summary LR, 11.4 [95% CI, 2.7-35] for atypical lymphocytes ≥10%, 26 [95% CI, 9.6-68] for those with 20%, and 50 [95% CI, 38-64] for those with 40%). The combination of a patient having greater than 50% lymphocytes and greater than 10% atypical lymphocytes also is useful (specificity, 0.99; positive LR, 54 [95% CI, 8.4-189]).
CONCLUSIONS AND RELEVANCE
In adolescent and adult patients presenting with sore throat, the presence of posterior cervical, inguinal or axillary adenopathy, palatine petechiae, splenomegaly, or atypical lymphocytosis is associated with an increased likelihood of mononucleosis.
Topics: Adolescent; Adult; Axilla; Fatigue; Humans; Infectious Mononucleosis; Leukocyte Count; Lymphatic Diseases; Lymphocyte Count; Neck; Pharyngitis; Physical Examination; Purpura; Sensitivity and Specificity; Splenomegaly; Symptom Assessment; Young Adult
PubMed: 27115266
DOI: 10.1001/jama.2016.2111 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2023The aim: To analyze the current views on diagnosis and management of infectious mononucleosis in children. The purpose of our work is also a comparative characteristic...
OBJECTIVE
The aim: To analyze the current views on diagnosis and management of infectious mononucleosis in children. The purpose of our work is also a comparative characteristic of the incidence of infectious mononucleosis in Ukraine and the city of Poltava (2006-2022).
PATIENTS AND METHODS
Materials and methods: The data of scientific literature have been analyzed, using the bibliosemantic method of study. We used a retrospective analysis of statistical data on the incidence of infectious mononucleosis 2006-2022 and the most frequent cases of infectious pathology in children in the period 2019- 2022, and also conducted an analysis of the percentage of those vaccinated according to the vaccination calendar.
RESULTS
Results: We had an increase in the incidence in 2009, but in subsequent years it was in the range of 23-25.2 per 100.000 children. The incidence of patients diagnosed with infectious mononucleosis per 100.000 of the children population in the Poltava region is one of the lowest in Ukraine, accounting for 8.1 - 10.1% over the past 3 years, which can be explained by the decrease in visits by parents and their children to the hospital to avoid contact with patients with the coronavirus disease and the fact that our region also had rather lower rates of children with Covid-19 compared in Ukraine.
CONCLUSION
Conclusions: the situation with the spread of infectious mononucleosis in children in Ukraine is such that it causes concern, and when comparing the incidence in 2009 and 2022, the authors noted an increase in the overall incidence of this nosology by 5%.
PubMed: 37740967
DOI: 10.36740/WLek202308108 -
Revue Medicale de Liege Apr 2023A 28-year-old patient is admitted in the emergency department for management of localized pain in the left hypochondrium and left flank that appeared 48 hours before his...
A 28-year-old patient is admitted in the emergency department for management of localized pain in the left hypochondrium and left flank that appeared 48 hours before his visit to the emergency room. At the same time, the patient describes the presence of fever, odynophagia and myalgia present for 8 days. The clinical examination highlights the presence of multiple upper cervical and submandibular bilateral and soft adenopathies of about 1.5 cm. There is also an abdominal defense at the level of the left hypochondrium and the left flank. The exploration will attest the presence of a primary EBV infection associated with a splenic rupture complicated by hemoperitoneum without hemodynamic repercussions. This clinical case illustrates the presence of a rare and potentially fatal complication following a very common disease, infectious mononucleosis.
Topics: Humans; Adult; Rupture, Spontaneous; Splenic Rupture; Infectious Mononucleosis; Epstein-Barr Virus Infections; Abdominal Pain
PubMed: 37067831
DOI: No ID Found -
BMJ Case Reports Apr 2021Gianotti-Crosti syndrome (GCS) is a self-limited condition, mainly affecting children younger than 6 years, less common in adolescents and adults. It consists of a viral...
Gianotti-Crosti syndrome (GCS) is a self-limited condition, mainly affecting children younger than 6 years, less common in adolescents and adults. It consists of a viral exanthema with papular lesions with a flat top and symmetrical distribution, affecting predominantly extremities, gluteal region and extensor surfaces. It is often associated with viral infections but can also be related to bacterial infections, vaccination or be idiopathic. In this report, we present a case of GCS in a 13-year-old healthy female adolescent who presented with fever, odynophagia, prostration and diffuse maculopapular rash. The diagnosis of infectious mononucleosis due to infection by the Epstein-Barr virus was established. On the second week of the disease, a clinical recrudescence occurred, with worsening of the fever and modification of the exanthema characteristics. GCS is often an underdiagnosed entity. The differential diagnosis of viral exanthema can prove to be challenging and clinical suspicion is essential to achieve the diagnosis.
Topics: Acrodermatitis; Adolescent; Child; Epstein-Barr Virus Infections; Exanthema; Female; Herpesvirus 4, Human; Humans; Infectious Mononucleosis
PubMed: 33795277
DOI: 10.1136/bcr-2020-240747 -
Clinical Infectious Diseases : An... Dec 2021
Topics: Epstein-Barr Virus Infections; Fatigue Syndrome, Chronic; Herpesvirus 4, Human; Humans; Infectious Mononucleosis; Students
PubMed: 33508083
DOI: 10.1093/cid/ciab075 -
International Journal of Adolescent... Jan 2019
Topics: Airway Obstruction; History, 19th Century; History, 20th Century; History, Medieval; Humans; Infectious Mononucleosis; Sepsis; Splenic Rupture
PubMed: 30645196
DOI: 10.1515/ijamh-2018-0284