infectious diseases
Infectious Mononucleosis
Pathophysiology of Infectious Mononucleosis
After exposure in the oral cavity, EBV infects B lymphocytes. Morphologically abnormal (atypical) lymphocytes develop, mainly from CD8+ T cells that respond to the infection. After primary infection, EBV remains within the host, primarily in B lymphocytes, for life and undergoes intermittent asymptomatic shedding from the oropharynx. The virus is detectable in oropharyngeal secretions of 10 to 20% of healthy EBV-seropositive adults ( Pathophysiology reference ). Shedding increases in frequency and titer in patients who are immunocompromised (eg, organ allograft recipients, people living with HIV). EBV has not been recovered from environmental sources and is not very contagious. Transmission may occur via transfusion of blood products but much more frequently occurs via kissing between an uninfected and an EBV-seropositive person who is shedding the virus asymptomatically. Only about 5% of patients acquire EBV from someone who has acute infection ( Pathophysiology reference ). Early childhood transmission occurs more frequently among lower socioeconomic groups and in crowded conditions. EBV is statistically associated with and likely has a causal role in Burkitt Lymphoma None Certain B-cell tumors in patients who are immunocompromised Certain forms of Hodgkin lymphoma Nasopharyngeal Cancer None Certain gastric cancers Multiple Sclerosis (MS) None EBV does not cause Chronic Fatigue Syndrome . However, it rarely causes a syndrome that may include fever, interstitial pneumonitis, pancytopenia, hepatitis, or uveitis (ie, chronic active EBV). 1. Johannsen EC, Kaye KM: Epstein-Barr Virus (Infectious Mononucleosis, Epstein-Barr Virus–Associated Malignant Diseases, and Other Diseases). InMandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases(Ninth Edition), Elsevier, 2020, pp. 138, 1872-1890, 2020 . ISBN: 9996119890, 9789996119897 