Heterophile Antibody Titer

Fig. 9-5. Characteristic EBV-specific antibody responses during EBV-induced infectious mononucleosis. (Adapted from Henle G, Henle W, Horowitz CA. Epstein-Barr virus specific diagnostic tests in infectious mononucleosis. Hum Pathol 1974;5:551, with permission.)

Table 9-17. Causes of Atypical Lymphocytosis

A. Infections

1. Bacterial: brucellosis, tuberculosis

2. Viral: mumps, varicella, rubeola, rubella, atypical pneumonia, herpes simplex, herpes zoster, roseola infantum

3. Protozoal: toxoplasmosis

4. Rickettsial: rickettsialpox

5. Spirochetal: congenital syphilis, tertiary syphilis

B. Radiation

C. Miscellaneous

1. Hematologic: Langerhans cell histiocytosis, leukemia, lymphoma, agranulocytosis

2. Other: lead intoxication, stress

II. More than 20%

A. Infectious mononucleosis

B. Infectious hepatitis

C. Post-transfusion syndrome

D. Cytomegalovirus syndrome

E. Drug hypersensitivity: p-aminosalicylic acid (PAS), phenytoin (Dilantin), mephenytoin (Mesantoin), organic arsenicals

Table 9-18. Complications of Infectious Mononucleosis

Neurologic: Bell palsy, cerebellar syndrome, meningoencephalitis, Guillain-Barre syndrome, myelitis, peripheral neuritis, radiculoneuritis, convulsions, coma Cardiac: myocarditis, pericarditis

Respiratory: laryngeal obstruction, peritonsillar abscess, respiratory obstruction, pleural effusion, pneumonitis Hematologic: acquired hemolytic anemia (usually Coombs' positive), immunopathic thrombocytopenic purpura, neutropenia, pancytopenia, aplastic anemia, eosinophilia, splenic rupture

Oncologic: nasopharyngeal carcinoma, Burkitt lymphoma, Hodgkin disease, lymphoproliferative disease, nasal T cell/natural killer cell lymphoma, lymphomatoid granulomatosis, angioimmunoblastic lymphadenopathy, central nervous system lymphoma in immunocompromised host, smooth muscle tumors in transplant patients, gastric carcinoma, peripheral T cell lymphoma with virus-associated hemophagocytic syndrome (see Chapter 13) In HIV patients with AIDS: oral hairy leukoplakia, lymphoid interstitial pneumonitis, non-Hodgkin lymphoma Renal: nephritis, nephrotic syndrome, hematuria, hemoglobinuria, proteinuria Hepatic: jaundice, hepatic dysfunction, hepatic necrosis, Reye syndrome Gastrointestinal: protein-losing enteropathy, melena, pancreatitis Genitourinary: orchitis, azoospermia, endocervicitis

Ocular: eyelid edema, conjunctivitis, papilledema, uveitis, nystagmus, diplopia, retro-orbital pain, scotomata aMay precede, follow, or occur simultaneously with acute phase of disease. Brain, meninges, spinal cord, and cranial and peripheral nerves may be involved separately or in combination, producing bizarre neurologic signs and symptoms.

Was this article helpful?

0 0

Post a comment