Epstein-Barr Virus

• What is the most prevalent infection caused by Epstein-Barr Virus (EBV)?


  Infectious mononucleosis (also known as glandular fever)
• Pathophys - EBV infection


  Alternates between lytic & latent life cycles

  Lytic

  • EBV infects oropharyngeal B cells & spreads to liver, spleen & lymph nodes via blood
  • production of antibodies against viral capsid antigens, early antigens & nuclear antigens

  Latent

  • EBV becomes latent in infected B cells -> immortalises lymphocytes -> forms continuous cell lines
  • Low-level viral replication in tonsillar and lymphoid tissues is controlled by EBV-specific T cells
• What are the RFs of EBV infection?


  Kissing

  Sexual behaviour
• What are the signs & symptoms of EBV infection?


  Fever

  General malaise

  Sore throat

  Transient macular rash

  Lymphadenopathy (esp in neck region)

  Mild hepatosplenomegaly
• What are the DDx of EBV infection?


  Streptococcal pharyngitis

  Influenza

  HIV seroconversion

  Cytomegalovirus
• What are the Inx of EBV infection?

  Obs

  Full Hx & examination

  HIV test -> presents similar

  Bloods (FBC, LFTs)

  Monospot test -> should be done within 2nd week of illness

  EBV viral serology

  Abdo USS
• What is the management of EBV infection?


  Conservative -> usually resolves within 2-4 weeks w/o intervention

  Analgesia

  Refrain from alcohol during illness

  Ampicillin & amoxicillin should be avoided -> can trigger itchy maculopapular rash

  Contact sports should be avoided for at least 3 weeks -> risk of splenic trauma
• What are the possible complications of EBV infection?


  Splenic rupture

  Chronic active EBV infection

  Haemophagocytic lymphohistiocytosis

  Aplastic anaemia

  Acute liver failure

  Upper airway obstruction