Epstein-Barr virus - Revision history

Aidan: /* PCR */

2023-06-07T20:20:50Z

PCR

← Older revision		Revision as of 20:20, 7 June 2023
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	*Useful for diagnosis of:		*Useful for diagnosis of:
	**Rare, [[chronic active Epstein-Barr virus]]		**Rare, [[chronic active Epstein-Barr virus disease]]
	**Early [[post-transplant lymphoproliferative disease]]		**Early [[post-transplant lymphoproliferative disease]]
	**[[Nasopharyngeal carcinoma]]		**[[Nasopharyngeal carcinoma]]

Aidan: /* Point-of-Care Testing */

2022-08-30T21:14:48Z

Point-of-Care Testing

← Older revision		Revision as of 21:14, 30 August 2022
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	**Less sensitive (10-50%) in young children (<4 years; lowest in those less than 2 years), with much lower negative predictive power		**Less sensitive (10-50%) in young children (<4 years; lowest in those less than 2 years), with much lower negative predictive power
	**Peak 2 to 5 weeks after symptom onset then usually decline quickly, but can persist for up to 6 to 12 months		**Peak 2 to 5 weeks after symptom onset then usually decline quickly, but can persist for up to 6 to 12 months
	**False positives are rare but can happen with rheumatoid disease, SLE, leukemia, lymphoma, and other infections including [[malaria]], [[HIV]], [[CMV]], [[rubella]], [[viral hepatitis]] and [[tularemia]], and after administration of [[anti-thymocyte globulin]]		**False positives are rare but can happen with rheumatoid disease, [[SLE]], [[leukemia]], [[lymphoma]], and other infections including [[malaria]], [[HIV]], [[CMV]], [[rubella]], [[viral hepatitis]] and [[tularemia]], and after administration of [[anti-thymocyte globulin]]

	===Serology===		===Serology===

Aidan: /* PCR */

2022-02-18T16:27:26Z

PCR

← Older revision		Revision as of 16:27, 18 February 2022
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	*Useful for diagnosis of:		*Useful for diagnosis of:
	**Rare, chronic ~~infection~~		**Rare, [[chronic active Epstein-Barr virus]]
	**Early post-transplant lymphoproliferative disease		**Early [[post-transplant lymphoproliferative disease]]
	**Nasopharyngeal ~~cancer~~		**[[Nasopharyngeal carcinoma]]
	*As well as monitoring response to treatment		*As well as monitoring response to treatment

Aidan at 01:35, 16 October 2020

2020-10-16T01:35:47Z

← Older revision		Revision as of 01:35, 16 October 2020
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	===Serology===		===Serology===

			*Reviewed in [[CiteRef::de paschale2012se]]
	*'''Anti-VCA''' (viral capsid antigens): most useful		*'''Anti-VCA''' (viral capsid antigens): most useful
	**Anti-VCA IgM: appears by presentation and disappears within 4 to 6 weeks; most useful with acute and convalescent		**Anti-VCA IgM: appears by presentation and disappears within 4 to 6 weeks; most useful with acute and convalescent

Aidan at 00:43, 16 October 2020

2020-10-16T00:43:57Z

← Older revision		Revision as of 00:43, 16 October 2020
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	===Microbiology===		===Microbiology===

			*A member of the ''Gammaherpesvirinae'' subfamily within the [[Herpesviridae]] family
	*A gamma-1 [[human herpesvirus\|herpesvirus]]
	*Double-stranded DNA inside an icosahedral protein nucleocapsid surrounded by a lipid envelope with glycoproteins		*Double-stranded DNA inside an icosahedral protein nucleocapsid surrounded by a lipid envelope with glycoproteins
	*Two strains (type 1 and 2) are serologically identical, but have unique epitopes		*Two strains (type 1 and 2) are serologically identical, but have unique epitopes
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	*Heterophile antibody may be negative if young; about 80% are positive by 4 years, though		*Heterophile antibody may be negative if young; about 80% are positive by 4 years, though

	===Infectious ~~mononucleosis~~===		===Infectious Mononucleosis===

	*Caused by primary infection, typically in an adolescent or young adult		*Caused by primary infection, typically in an adolescent or young adult
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	**Often has splenomegaly, may have hepatomegaly, and rarely has jaundice		**Often has splenomegaly, may have hepatomegaly, and rarely has jaundice
	*With exposure to [[amoxicillin]], almost all patients develop a diffuse maculopapular rash		*With exposure to [[amoxicillin]], almost all patients develop a diffuse maculopapular rash
	*May have transient heterophile antibodies, as well as [[Causes::atypical lymphocytosis]]		*May have transient heterophile antibodies (see Diagnosis, below), as well as [[Causes::atypical lymphocytosis]]
	*Resolves over 2 to 3 weeks, with fevers lasting up to 14 days, and fatigue lasting months		*Resolves over 2 to 3 weeks, with fevers lasting up to 14 days, and fatigue lasting months

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	*'''Neurologic''' complications include meningitis, encephalitis, Guillain-Barré syndromes, optic neuritis, retrobulber neuritis, cranial nerve palsies, mononeuritis multiplex, brachial plexus neuropathy, seizures, subacute sclerosing panencephalitis, transverse, myelitis, psychosis, demyelination, and hemiplegia		*'''Neurologic''' complications include meningitis, encephalitis, Guillain-Barré syndromes, optic neuritis, retrobulber neuritis, cranial nerve palsies, mononeuritis multiplex, brachial plexus neuropathy, seizures, subacute sclerosing panencephalitis, transverse, myelitis, psychosis, demyelination, and hemiplegia

	===Chronic Active EBV===		===Chronic Active EBV Disease===

			*See also [[Chronic active Epstein-Barr virus disease]]
	*Classically in Japan and east Asia, possibly South America		*Classically in Japan and east Asia, possibly South America
	*Progressive disease related to infection of NK or T cells rather than B cells		*Progressive disease related to infection of NK or T cells rather than B cells
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	*'''Monospot''' latex agglutination looking for '''heterophile antibodies'''		*'''Monospot''' latex agglutination looking for '''heterophile antibodies'''
	**80-95% sensitive and 98-100% specific, overall		**50% sensitive in the first week of illness, but up to 80-95% sensitive by the third week, and 98-100% specific, overall
	**Less sensitive (10-50%) in young children (<4 years), with much lower negative predictive power		**Less sensitive (10-50%) in young children (<4 years; lowest in those less than 2 years), with much lower negative predictive power
			**Peak 2 to 5 weeks after symptom onset then usually decline quickly, but can persist for up to 6 to 12 months
	**False positives are rare but can happen with rheumatoid disease, SLE, leukemia, lymphoma, and other infections including [[malaria]], [[HIV]], [[CMV]], [[rubella]], [[viral hepatitis]] and [[tularemia]], and after administration of [[anti-thymocyte globulin]]		**False positives are rare but can happen with rheumatoid disease, SLE, leukemia, lymphoma, and other infections including [[malaria]], [[HIV]], [[CMV]], [[rubella]], [[viral hepatitis]] and [[tularemia]], and after administration of [[anti-thymocyte globulin]]

Aidan: /* Clinical Manifestations */

2020-09-13T19:10:20Z

Clinical Manifestations

Show changes

Aidan: /* Infectious mononucleosis */

2020-08-05T14:03:09Z

Infectious mononucleosis

← Older revision		Revision as of 14:03, 5 August 2020
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	* Caused by primary infection, typically in an adolescent or young adult		* Caused by primary infection, typically in an adolescent or young adult
	* EBV causes about 80% of mononucleosis, with the rest being [[CMV]]		* EBV causes about 80% of mononucleosis, with the rest being [[CMV]]
	* Incubation period 30 to 50 days, and can have asymptomatic viral shedding for up to a month before symptoms		* Incubation period [[Usual incubation period::30 to 50 days]], and can have asymptomatic viral shedding for up to a month before symptoms
	* Symptoms include a triad of sore throat, fever, and lymphadenopathy (classically posterior cervical chain)		* Symptoms include a triad of sore throat, fever, and lymphadenopathy (classically posterior cervical chain)
	** Often preceded by prodromal symptoms of chils, sweats, anorexia, and malaise		** Often preceded by prodromal symptoms of chils, sweats, anorexia, and malaise

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-19T13:31:28Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 13:31, 19 July 2020
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	* Response also creates IgM antibodies to sheep, horse, and cow RBCs, called '''heterophile antibodies'''		* Response also creates IgM antibodies to sheep, horse, and cow RBCs, called '''heterophile antibodies'''

	== Clinical ~~Presentation~~ ==		== Clinical Manifestations ==
	=== Childhood ===		=== Childhood ===
	* In childhood, mostly asymptomatic or mild febrile illness		* In childhood, mostly asymptomatic or mild febrile illness

Aidan: /* Point-of-care testing */ typo

2020-01-28T00:07:35Z

Point-of-care testing: typo

← Older revision		Revision as of 00:07, 28 January 2020
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	** 80-95% sensitive and 98-100% specific, overall		** 80-95% sensitive and 98-100% specific, overall
	** Less sensitive (10-50%) in young children (<4 years), with much lower negative predictive power		** Less sensitive (10-50%) in young children (<4 years), with much lower negative predictive power
	** False positives are rare but can happen with rheumatoid disease, SLE, leukemia, lymphoma, and other infections including [[malaria]], [[HIV]], [[CMV]], [[rubella]], [[viral hepatitis]] and [[tularemia]], and after		** False positives are rare but can happen with rheumatoid disease, SLE, leukemia, lymphoma, and other infections including [[malaria]], [[HIV]], [[CMV]], [[rubella]], [[viral hepatitis]] and [[tularemia]], and after administration of [[anti-thymocyte globulin]]
	administration of [[anti-thymocyte globulin]]

	=== Serology ===		=== Serology ===

Aidan: /* Point-of-care testing */ added more false positives

2019-11-27T22:01:38Z

Point-of-care testing: added more false positives

← Older revision		Revision as of 22:01, 27 November 2019
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	** 80-95% sensitive and 98-100% specific, overall		** 80-95% sensitive and 98-100% specific, overall
	** Less sensitive (10-50%) in young children (<4 years), with much lower negative predictive power		** Less sensitive (10-50%) in young children (<4 years), with much lower negative predictive power
			** False positives are rare but can happen with rheumatoid disease, SLE, leukemia, lymphoma, and other infections including [[malaria]], [[HIV]], [[CMV]], [[rubella]], [[viral hepatitis]] and [[tularemia]], and after
	** False positive with acute HIV seroconversion
			administration of [[anti-thymocyte globulin]]

	=== Serology ===		=== Serology ===