《儿科学教点学课件》17传染性单核细胞增多症（上）.ppt

Infectious Mononucleosis (IM) Introduction Infectious mononucleosis(IM) is an infectious disease caused by Epstein-Barr virus(EBV) . The clinical features include fever, pharyngitis , and generalized lymphadenopathy. The characteristics of lab study is atypical lymphocytosis in the peripheral blood. Etiology Epstein-Barr virus(EBV) 1. Classification： double-stranded DNA virus ---Family: Herpesviridae ---Subfamily: γ-herpesvirinae 2. Characteristics of EBV Latent-reactive Lymphotropic virus just infecting B-LC capacity to have B lymphocyte proliferate infinitely (immortalization ) Etiology 3、Viral Antigen Systems viral capsid antigen, VCA EB nuclear antigen, EBNA early antigen, EA lymphocyte-detected membrane antigen, LYDMA membrane antigen, MA Epidemiology 1. Infectious sources Patients, persons with latent infection and carriers 2. Routes of transmission ： Contact transmission through the mouth (exchange of saliva) blood transmission occasionally 3. Population susceptibility School age children and adolescents 4. Epidemiological features Peak seasons Epidemiological status Pathogenesis Pathology The basic pathological change is the benign lymphadenosis The main damage is in monocyte-macrophage system Lymph nodes：non-pyogenic lymphadenectasis with LC and monocyte-macrophage system proliferation Spleen: lots of atypical LC LC infiltration and limited necrotic lesions in organs such as liver, heart, kidney, lung, CNS,etc. Manifestations The incubation period ：5~15 days 1. fever 2. pharyngitis: 80%. sore throat, tonsillar enlargement, hyperemia , edema and exudates（50%） 3. generalized lymphadenopathy： 80~100%. The most common lymphadenopathy is enlargement of cervical lymph nodes 4. splenohepatomegalia: hepatomegaly： 30~50%. Among them, 2/3 has elevated liver enzymes Jaundice is uncommon. Liver failure may occurred in few case