Epstein-Barr Virus (EBV) Infectious Mononucleosis (Mono) Questions & Answers

Updated: Sep 20, 2018
  • Author: Burke A Cunha, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Questions & Answers

Overview

When was Epstein-Barr virus (EBV) infectious mononucleosis (mono) first described and how was it characterized?

How is Epstein-Barr virus (EBV) transmitted (the virus that causes infectious mononucleosis [mono])?

What is the pathophysiology of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What is the role of the T-lymphocyte cellular response in determining the clinical expression of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How does the physiologic response to the Epstein-Barr virus (EBV) cause the symptoms of infectious mononucleosis (mono)?

How common is Epstein-Barr virus (EBV) infectious mononucleosis (mono) in the US?

How is fatigue characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What are the mortality and morbidity rates of Epstein-Barr virus (EBV) infectious mononucleosis (mono), and which characteristics or complications of the virus are associated with severe illness or death?

How is posttransplant lymphoproliferative disorder (PTLD) acquired from Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When can Epstein-Barr virus (EBV) infectious mononucleosis (mono) result in malignancy, and which malignant conditions are associated with EBV?

What are some of the neoplasms caused by Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What are the age-related demographics of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Presentation

Do all people with Epstein-Barr virus (EBV) infectious mononucleosis (mono) have symptoms?

What is the incubation period of Epstein-Barr virus (EBV) infectious mononucleosis (mono) and what are the common presenting symptoms?

Which symptoms are associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which physical findings are associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What is the predisposing risk factor associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Where in the body does Epstein-Barr virus (EBV) persist in infectious mononucleosis (mono)?

Which comorbidities are associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono) in patients with congenital immunodeficiencies?

Which comorbidities are associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono) in patients with acquired immunodeficiencies?

Which geographic location is predisposed to Burkitt lymphoma in children with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

DDX

How is fever in Epstein-Barr virus (EBV) infectious mononucleosis (mono) distinguished from fever associated with other conditions?

What is the presentation of pharyngitis in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which conditions in addition to Epstein-Barr virus (EBV) infectious mononucleosis (mono) are associated with palatal petechiae?

What does uvular edema indicate in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is posterior oropharynx characterized in patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) and how does it compare with the findings in chronic fatigue syndrome (CFS)?

How is heterophile-negative infectious mononucleosis (mono) differentiated from Epstein-Barr virus (EBV) mono?

How is lymphadenopathy distinguished from Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which signs and symptoms differentiate rubella from Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is acquired toxoplasmosis distinguished from Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is HHV-6 infection distinguished from Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What is the presentation of Epstein-Barr virus (EBV) infectious mononucleosis (mono) in patients with HIV infection?

How is anicteric hepatitis differentiated from Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which signs and symptoms are findings in both cytomegalovirus (CMV) mononucleosis (mono) and Epstein-Barr virus (EBV) infectious mono and how are they distinguished?

How is drug-induced pseudolymphoma differentiated from Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is anicteric hepatitis differentiated from Epstein-Barr virus (EBV) infectious mononucleosis (mono) in elderly patients?

How is splenomegaly characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono) and how is it differentiated from other conditions that also present with splenomegaly?

How is a finding of leukocytosis used to confirm or exclude Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is lymphocytosis characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is thrombocytopenia characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How are serum transaminases characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono), and which mononucleosislike illnesses may be indicated by other findings?

How is the erythrocyte sedimentation rate (ESR) measurement used in the diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What does a maculopapular rash contribute to the clinical picture in the diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is the rash associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono) characterized?

How is the rash of rubella differentiated from the rash that occurs with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is the external eye involvement of Epstein-Barr virus (EBV) infectious mononucleosis (mono) characterized, and what other findings of the periorbital area suggest a different diagnosis?

How common is splenic rupture in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What are the diagnostic considerations for meningoencephalitis in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What is the role of fatigue in the diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is fatigue characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono) and what does chronic fatigue suggest?

How common is chronic infectious mononucleosis (mono) and how is it differentiated from chronic fatigue syndrome (CFS)?

Workup

Which antibodies does an Epstein-Barr virus (EBV) mononucleosis (mono) infection induce?

What is the sensitivity and specificity of the heterophile antibody test in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What is the sensitivity and specificity of the latex agglutination assay in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is the heterophile antibody test used to differentiate heterophile-negative infectious mononucleosis (mono) and Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is testing for Epstein-Barr virus (EBV)-specific antibodies used in the workup of infectious mononucleosis (mono)?

Which nonspecific tests are included in the workup for Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which lab studies are specific for Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which other tests may be indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When are imaging studies indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When is an EEG indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When is a bone marrow or lymph node biopsy indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When is a lumbar puncture indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What do histologic findings demonstrate in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Treatment

How are patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) monitored and when are steroids used for treatment?

When is surgery indicated in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which consultations may be necessary in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What type of diet is appropriate in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What level of activity is encouraged in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Medications

Is antiviral therapy available in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Is antiviral therapy available for immunocompromised patients with Epstein-Barr virus (EBV) lymphoproliferative disease?

When are corticosteroids indicated in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is group A streptococcal (GAS) infection treated in patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Follow-up

How are patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) monitored?

What do patients need to know about fatigue and how Epstein-Barr virus (EBV) infectious mononucleosis (mono) titers?

What does extreme tonsillar enlargement indicate in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How can patients avoid contracting Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What are complications associated with infectious mononucleosis (mono)?

What is the prognosis of splenic rupture in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What do patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) need to know about physical activity restrictions?

How can patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) prevent spreading the disease to others?

What patient education resources are available for Epstein-Barr virus (EBV) infectious mononucleosis (mono)?