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Infectious Mononucleosis, Epstein-Barr Virus Infections

Dennis E Hughes, DO FACEP Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Epstein-Barr virus (EBV) is a member of the gamma herpes virus family; human herpes virus 4.

    • Two subtypes: ST1 predominates in Western Hemisphere, Southeast Asia; ST1 and ST2 equally ...

DIAGNOSIS

Diagnostic accuracy of clinical signs and symptoms varies. 

HISTORY

  • May be either abrupt or insidious in onset

  • Syndrome of fatigue, malaise, and sore throat

  • In adults, temperature may rise to 10...

TREATMENT

  • Treatment is primarily supportive.

  • NSAIDs or acetaminophen

  • During acute stage, limit activity for 4 weeks to reduce potential complications (e.g., splenic rupture).

  • Transplant recipients who d...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

ALERT

Rupture of the spleen may be fatal if not recognized; it requires blood transfusions, treatment for shock, and splenectomy. Occurrence is estimated at 0.1%.

 

Patient Monitoring

REFERENCES

1
Yu H, Robertson ES. Epstein-Barr virus history and pathogenesis. Viruses. 2023;15(3):714. doi: 10.3390/v15030714.
2
Houen G, Trier NH. Epstein-Barr virus and systemic autoimmune diseases. Fr...

CODES

ICD10

  • B27.00 Gammaherpesviral mononucleosis without complication

  • B27.09 Gammaherpesviral mononucleosis with other complications

  • B27.01 Gammaherpesviral mononucleosis with polyneuropathy

  • B27.02 Gamma...

CLINICAL PEARLS

  • 98% of patients with acute IM present with some combination of fever, sore throat, cervical node enlargement, and tonsillar hypertrophy.

  • False-negative monospot (heterophile antibody) i...

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