《儿科学教学讲义》传染性单核细胞增多症上.pptVIP

Infectious Mononucleosis (IM) Liu Quanbo, associate professor DIVISION OF INFECTIOUS DISEASE OF CHONGQING MEDICAL UNIVERSITY 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 ) Epstein-Barr virus(EBV) 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 EBV salivary glands infects oral epithelial cells and B-LC in pharynx pharyngitis Lymphadenopathy in cervical nodes excrete EBV Continuously or intermittently B-LC in the peripheral blood and the entire lymphoreticular system viremia Activation of polyclonal B-LC polyclonal antibodies Specific Abs heterophil Ab autoantibody Tc responsed to the infected B-LC Effect on B-LC containing EBV atypical LC↑ Hepatosplenomegaly, lymphadenectasis, myocarditis, pneumonia, etc. Changes of antigenicity on the surface of B-LC Specific Abs 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-macro