《儿科学》INFECTIOUS MONONUCLEOSIS.pptVIP

INFECTIOUS MONONUCLEOSIS(epstein-barr virus) Professor: Ma lian Typical features Prolong fever Exudative pharyngitis Generalized adenopathy Hepatosplenomegaly Atypical lymphocytes Heterophil antibodies General considerations Infectious mononucleosis (mono) is a common acute infectious disease usually found in individuals between the ages of 5 and 30.? Pathogeny Epstein-Barr virus (90%) CMV, HIV, HHV-6, toxoplasma gondii, Hepatitis virus etc (5-10%). EBV Occur worldwide Transmitted by saliva and blood transfusion Related with the following diseases Mono Burkitt lymphoma Nasopharyngeal cancer Clinical findings Symptoms and signs Prolong fever(39℃) Soft palate petechiae and Exudative pharyngitis Generalized adenopathy Splenomegaly and hepatomegaly Rash (macular,scarlatiniform or urticarial) eye edema X-linked lymphoproliferative syndrome (XLP): occur in the children with primary immunodeficiency disease Sore throat Generalized adenopathy Rash Clinical findings Laboratory findings Peripheral blood Atypical lymphocytes Leukopenia Heterophil antibodies Anti-EBV antibodies aminotransferase No clumping of the red bloods cells indicates the persons serum does not contains heterophile antibodies. The few clumps that are seen are red blood cells from the test reagent that did not separate during shaking of the reagent prior to placing it on the slide. Differantial diagnosis Group A streptococcal infection Rubella Adenovirus Hepatitis A or B Toxoplasmosis Drug reaction Leukemia CMV mononucleosis HIV infection Complication CardiorespiratoryInterstitial pneumonitisMyocarditisPericarditisPleuritis HematologicAutoimmune hemolytic anemiaImmune granulocytopenia or thrombocytopeniaPancytopenia Complication HepaticCholestatic jaundice (severe hepatitis)Massive hepatic necrosis and failure NeurologicCranial nerve palsiesGuillain-Barré syndromeMeningoencephalitisTransverse myelitisOthers Infectious mononucleosis hepatitis Marked mononuclear cell infiltration