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Sections Pediatric Mononucleosis and Epstein-Barr Virus Infection
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Guidelines
- Medication
- Follow-up
- References
Guidelines Summary
Guidelines on the diagnosis, prevention, prophylaxis, and treatment of Epstein-Barr virus (EBV)–related post transplant lymphoproliferative disorders in allogeneic hematopoietic stem cell transplant patients were published in 2016 by the Sixth European Conference on Infections in Leukemia. The guidelines recommend rituximab, immunosuppression reduction, and EBV-specific cytotoxic T-cell therapy as first-line treatment in these patients. Unselected donor lymphocyte infusions and chemotherapy are recommended as second-line options, while antiviral drugs are not recommended for prophylaxis, with evidence indicating that they are ineffective against latent EBV. [57]
A Cochrane review, which included 7 randomized controlled trials and 333 patients, found that the efficacy of antivirals (eg, acyclovir, valaciclovir) in infectious mononucleosis is uncertain, and the quality of evidence is very low. [53] An improvement in time taken to recover (by 5 days) occurred in patients who received antiviral treatment, but the result was not precise and measurement for improvement was not clearly defined.
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Infectious mononucleosis. Antibody response to Epstein-Barr virus. Adapted with permission from Johnson DH, Cunha BA. Epstein-Barr virus serology. Infect Dis Pract. 1995;19:26-27.
Tables
Jaya Sureshbabu, MBBS, MRCPCH(UK), MRCPI(Paeds), MRCPS(Glasg), DCH(Glasg) Consultant Neonatologist and Pediatrian, Sree Gokulam Medical College and Research Foundation, India
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Mark R Schleiss, MD Minnesota American Legion and Auxiliary Heart Research Foundation Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School
Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Society for Pediatric Research
Disclosure: Nothing to disclose.
Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association
Disclosure: Nothing to disclose.
Joseph Domachowske, MD Professor of Pediatrics, Microbiology and Immunology, Department of Pediatrics, Division of Infectious Diseases, State University of New York Upstate Medical University
Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa
Disclosure: Received research grant from: Pfizer;GlaxoSmithKline;AstraZeneca;Merck;American Academy of Pediatrics, Novavax, Regeneron, Diassess, Actelion<br/>Received income in an amount equal to or greater than $250 from: Sanofi Pasteur.
Nicholas John Bennett, MBBCh, PhD, FAAP, MA(Cantab) Assistant Professor of Pediatrics, Co-Director of Antimicrobial Stewardship, Medical Director, Division of Pediatric Infectious Diseases and Immunology, Connecticut Children's Medical Center
Nicholas John Bennett, MBBCh, PhD, FAAP, MA(Cantab) is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics
Disclosure: Received research grant from: Cubist<br/>Received income in an amount equal to or greater than $250 from: Horizon Pharmaceuticals, Shire<br/>Medico legal consulting for: Various.
Rosemary Johann-Liang, MD Medical Officer, Infectious Diseases and Pediatrics, Division of Special Pathogens and Immunological Drug Products, Center for Drug Evaluation and Research, Food and Drug Administration
Rosemary Johann-Liang, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.
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Sections Pediatric Mononucleosis and Epstein-Barr Virus Infection
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Guidelines
- Medication
- Follow-up
- References
