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Pathology - Infectious mononucleosis
Pathogen: Epstein–Barr virus (EBV), a DNA herpesvirus. Epidemiology • The majority of patients are adolescents or young adults. • Absence of gender or racial bias.
• Transmission occurs via saliva or respiratory droplets from an individual infected with EBV.
• Incubation duration of 4–5 weeks.
Mechanism of Disease
Development EBV infects oropharyngeal epithelial cells through the C3d receptor and replicates within these cells. EBV infects B-lymphocytes, causing the linear genome to circularize and survive as an episome.
Viral persistence facilitates continuous multiplication within oropharyngeal epithelial cells and the secretion of infectious particles into saliva. Presentation: sore throat, fever, malaise.
Clinical examination may disclose lymphadenopathy, palatal petechiae, and splenomegaly.
Diagnosis: Lymphocytosis. • The peripheral blood film reveals big atypical cells, which are not specific to EBV. • Ninety percent possess heterophil antibodies (Paul–Bunnell; Monospot test). • EBV-specific IgM antibodies indicate a current infection.
Histopathology
• Lymph nodes and tonsils exhibit significant paracortical growth due to massive lymphoid blasts comprising a mixture of B- and T-cells. The EBV-LMP1 antigen can be identified immunohistochemically in some B-blasts.
Prognosis: In the majority of instances, the condition is self-limiting. • Uncommon consequences encompass meningitis, encephalitis, cranial nerve lesions, Guillain–Barré syndrome, depression, and fatigue.
Pathogen: Epstein–Barr virus (EBV), a DNA herpesvirus. Epidemiology • The majority of patients are adolescents or young adults. • Absence of gender or racial bias.
• Transmission occurs via saliva or respiratory droplets from an individual infected with EBV.
• Incubation duration of 4–5 weeks.
Mechanism of Disease
Development EBV infects oropharyngeal epithelial cells through the C3d receptor and replicates within these cells. EBV infects B-lymphocytes, causing the linear genome to circularize and survive as an episome.
Viral persistence facilitates continuous multiplication within oropharyngeal epithelial cells and the secretion of infectious particles into saliva. Presentation: sore throat, fever, malaise.
Clinical examination may disclose lymphadenopathy, palatal petechiae, and splenomegaly.
Diagnosis: Lymphocytosis. • The peripheral blood film reveals big atypical cells, which are not specific to EBV. • Ninety percent possess heterophil antibodies (Paul–Bunnell; Monospot test). • EBV-specific IgM antibodies indicate a current infection.
Histopathology
• Lymph nodes and tonsils exhibit significant paracortical growth due to massive lymphoid blasts comprising a mixture of B- and T-cells. The EBV-LMP1 antigen can be identified immunohistochemically in some B-blasts.
Prognosis: In the majority of instances, the condition is self-limiting. • Uncommon consequences encompass meningitis, encephalitis, cranial nerve lesions, Guillain–Barré syndrome, depression, and fatigue.
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