scholarly journals Infectious Mononucleosis Presenting with Loss of Taste and Smell During the SARS-CoV-2 Pandemic?

2020 ◽  
Author(s):  
Krishna Nareshkumar Patel ◽  
Muhammad Hussein ◽  
Amir Khalil ◽  
Najeeb Rehman ◽  
Hazim Mahdi ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Close Contact ◽  
Blood Film ◽  
Progressive Dyspnoea ◽  
Barr Virus ◽  
History Of ◽  
Normal Chest ◽  
Chest X Ray ◽  
Epstein Barr ◽  
Taste And Smell

A 53-year-old woman presented during the SARS-CoV-2 pandemic with an 18-day history of pyrexia, myalgia, progressive dyspnoea and loss of taste and smell after a close contact had tested positive for SARS-CoV-2. In this period two swabs had been negative for SARS-CoV-2. Clinical examination was normal. During this admission a third SARS-CoV-2 swab was negative, and investigations showed mildly elevated inflammatory markers, mildly deranged liver function, atypical lymphocytes on a blood film and a normal chest x-ray. Her Epstein–Barr virus serology was positive and thus the diagnosis was infectious mononucleosis.

scholarly journals Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman

2020 ◽  
Vol 8 ◽  
pp. 232470962096161
Author(s):  
Shifang Wang ◽  
Shiyu Wang ◽  
Shaleindra Singh
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Infectious Mononucleosis ◽  
Lupus Erythematosus ◽  
Oral Intake ◽  
Low Grade ◽  
Systemic Lupus ◽  
Barr Virus ◽  
History Of ◽  
Epstein Barr ◽  
The Many

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by heterogeneous symptoms that can manifest in any organ, and often presents at a young age. Infectious mononucleosis (IM) is the acute clinical manifestation of Epstein–Barr virus (EBV). It is characterized by low-grade fever, malaise, lymphadenopathy, splenomegaly, and occasionally symmetrical arthralgias. It has been proposed that EBV is a trigger for new-onset SLE, and patients with autoimmune disorders such as SLE are more likely to have recurrent IM infections. The patient, a 64-year old Caucasian female who’s only past medical history was hypertension, developed several months–long period of vague symptoms, including fatigue, malaise, nausea, and nonbilious vomiting with oral intake. She presented with symmetrical polyarthritis involving the hands and elbows, with no history of arthritis before this episode. At the 5-month follow-up, she presented with worsening arthritis bilaterally in her elbows and in her right knee. For several decades, there has been a theoretical association between EBV and SLE, with EBV thought to be one of the many possible triggers for development of SLE. Based on the disease course, we theorize that the patient’s IM and EBV infection led to development of SLE. A small fraction of SLE cases have been reported in literature to be associated with EBV. This case adds to that literature with EBV triggering development of SLE in a seemingly previously asymptomatic patient.

Effects of infectious mononucleosis and HLA-DRB1*15 in multiple sclerosis

2009 ◽  
Vol 15 (4) ◽  
pp. 431-436 ◽  
Author(s):  
TR Nielsen ◽  
K Rostgaard ◽  
J Askling ◽  
R Steffensen ◽  
A Oturai ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Infectious Mononucleosis ◽  
Human Leukocyte ◽  
Epstein Barr Virus Infection ◽  
Leukocyte Antigen ◽  
Barr Virus ◽  
Increased Risk ◽  
History Of ◽  
Epstein Barr ◽  
Barr Virus Infection

Background Both human leukocyte antigen (HLA)-DRB1*15 and Epstein-Barr virus infection presenting as infectious mononucleosis (IM) are recognized as risk factors for multiple sclerosis (MS). However, their combined effect and possible interaction on MS risk is not known. Objective To assess the association between HLA-DRB1*15 and risk of MS in persons with and without IM. Methods We compared the prevalence of DRB1*15 in MS patients with ( n = 76) and without ( n = 1,836) IM with the corresponding distributions in blood donors with ( n = 62) and without ( n = 484) IM histories. This allowed us to estimate the relative risk of MS associated with DRB1*15 in the presence and absence, respectively, of previous IM. We then estimated the interaction between DRB1*15 and IM as the ratio of the two individual odds ratios. Results In IM-naïve individuals, DRB1*15 carried a 2.4-fold (95% confidence interval [CI], 2.0–3.0) increased MS risk. In contrast, among persons with IM history, DRB1*15 was associated with a 7.0-fold (95% CI, 3.3–15.4) increased MS risk. Thus, the MS risk conferred by HLA-DRB1*15 was 2.9 (95% CI, 1.3–6.5)-fold stronger in the presence than in the absence of IM. Combined with previous results, this result indicates that DRB1*15-positive persons with a history of IM may be at a 10.0-fold (95% CI, 6.0–17.9) increased risk of MS compared with persons who are DRB1*15 and IM-naïve. Conclusion DRB1*15 and IM may act in synergy causing MS.

Pyknotic Lymphocytes In Infectious Mononucleosis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4732-4732
Author(s):  
William A. Dittman
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Conflicts Of Interest ◽  
Time Lapse ◽  
Blood Film ◽  
Lymphoproliferative Disorders ◽  
Daily Routine ◽  
Antibody Testing ◽  
Barr Virus ◽  
Epstein Barr

Context Pyknotic lymphocytes were infrequently observed in routine blood film evaluation of patients with clinical infectious mononucleosis. A marked increase in frequency was observed in 1995-1997. Objective To characterize the cause of these changes. Design Collection of samples from patients (25) with clinical infectious mononucleosis to ascertain the effect of anticoagulant and/or time lapse on lymphocytes and to correlate with monospot or Epstein-Barr virus antibody testing. Control samples (33), mixed hematopoietic disease (29) and lymphoproliferative disorders (36) were obtained also. Additional patients (53), identified by variant lymphocyte morphology during routine CBC’s, were verified by monospot or EBV testing and slides were made at 24 and 48 hours for differentials. Finally, single specimens (86) were obtained to establish predictability or correlation between pyknotic cells and monospot testing Setting Inpatient and outpatient hematology laboratory. Results Patients with clinical infectious mononucleosis demonstrated 8-10% pyknotic lymphocytes in 24 and 48 hour samples in all three anticoagulants (see Figure 1) compared with controls, “other diseases” (Table 2) and lymphoproliferative disorders (Table 3). An unexpected predictive correlation of pyknotic cells with positive monospot or Epstein-Barr Virus antibodies was demonstrated when pyknotic cells were seen with or without significant atypical lymphocytes during daily routine differential counting. Conclusion Observation of pyknotic lymphocytes adds a significant and inexpensive element to the diagnosis of infectious mononucleosis and consideration of Cytomegalic Virus infection in older patient Disclosures: No relevant conflicts of interest to declare.

scholarly journals Evidence of genetic susceptibility to infectious mononucleosis: a twin study

2011 ◽  
Vol 140 (11) ◽  
pp. 2089-2095 ◽  
Author(s):  
A. E. HWANG ◽  
A. S. HAMILTON ◽  
M. G. COCKBURN ◽  
R. AMBINDER ◽  
J. ZADNICK ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Genetic Factors ◽  
Population Based ◽  
Epstein Barr Virus Infection ◽  
Barr Virus ◽  
History Of ◽  
Epstein Barr ◽  
Barr Virus Infection

SUMMARYInfectious mononucleosis is a clinical manifestation of primary Epstein–Barr virus infection. It is unknown whether genetic factors contribute to risk. To assess heritability, we compared disease concordance in monozygotic to dizygotic twin pairs from the population-based California Twin Program and assessed the risk to initially unaffected co-twins. One member of 611 and both members of 58 twin pairs reported a history of infectious mononucleosis. Pairwise concordance in monozygotic and dizygotic pairs was respectively 12·1% [standard error (s.e.)=1·9%] and 6·1% (s.e.=1·2%). The relative risk (hazard ratio) of monozygotic compared to dizygotic unaffected co-twins of cases was 1·9 [95% confidence interval (CI) 1·1–3·4, P=0·03], over the follow-up period. When the analysis was restricted to same-sex twin pairs, that estimate was 2·5 (95% CI 1·2–5·3, P=0·02). The results are compatible with a heritable contribution to the risk of infectious mononucleosis.

Diagnosis of infectious mononucleosis caused by Epstein-Barr virus in infants

2010 ◽  
Vol 52 (4) ◽  
pp. 536-540 ◽  
Author(s):  
Sumitaka Dohno ◽  
Akihiko Maeda ◽  
Yoshihito Ishiura ◽  
Tetsuya Sato ◽  
Mikiya Fujieda ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Barr Virus ◽  
Epstein Barr

scholarly journals Acute Acalculous Cholecystitis Due to a Primary Epstein Barr Virus Infection in a Pediatric Patient

2021 ◽  
Vol 13 (1) ◽  
pp. 86-90
Author(s):  
Carlos Leganés Villanueva ◽  
Ilaria Goruppi ◽  
Nuria Brun Lozano ◽  
Federica Bianchi ◽  
María Quinteiro González ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Epstein Barr Virus Infection ◽  
Barr Virus ◽  
Acute Complications ◽  
Epstein Barr ◽  
Barr Virus Infection ◽  
Human Viruses

Epstein–Barr virus (EBV) is estimated to infect more than 98% of adults worldwide and is one of the most common human viruses. Acute acalculous cholecystitis (AAC) of the gallbladder is an atypical complication of infectious mononucleosis caused by EBV. Conservative management has been described in the context of AAC caused by EBV. A surgical approach must be considered in the case of acute complications such as perforation or gallbladder gangrene. We present the case of a 10-year-old female patient with AAC due to infectious mononucleosis syndrome caused by primary EBV infection.

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