Research on infectious mononucleosis was also given priority over articles

Research on infectious mononucleosis was also given

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Research on infectious mononucleosis was also given priority over articles exclusively relating to Epstein-Barr virus. We also examined guidelines produced by the US Center for Disease Control and Prevention and the UK National Institute for Health and Care Excellence, as well as clinical trials registries of the United States, United Kingdom, and European Union. w1-w 3 PR J BERNARD/CNRI/SPL Infectious mononucleosis is commonly seen in both the community and the hospital setting. Patients usually pre- sent with a sore throat and often presume that an anti- biotic is required. It is therefore important to dispel the many myths relating to the condition with appropriate patient education. Knowledge of the clinical course of the disease, as well as potential complications, is paramount. In an information age, difficult questions may arise for a general practitioner, emergency doctor, or trainee in ear, nose, and throat medicine. The aim of this review is to assist those who encounter infectious mononucleosis in the adolescent and adult population. What is infectious mononucleosis and what causes it? It would be most accurate to consider infectious mono- nucleosis as a non-genetic syndrome, defined by the classic triad of fever, pharyngitis, and cervical lymphad- enopathy, where lymphocytosis is also present. For many doctors the terms Epstein-Barr virus and infectious mon- onucleosis are synonymous. Epstein-Barr virus causes approximately 90% of the cases of infectious mononu- cleosis, with the remainder due largely to cytomegalo- virus, human herpesvirus 6, toxoplasmosis, HIV, and adenovirus. 1 w4 The World Health Organization’s ICD-10 (international classification of diseases, 10th revision) has four subheadings for infectious mononucleosis (or B27 in the manual. w5 ) To confuse things further the mul- tiple synonyms for infectious mononucleosis (glandular fever, monocytic angina, Pfeiffer’s disease, Filatov’s disease, Drusenfieber, and even the kissing disease) are still included in ICD-9, which will be in use in the United States until 1 October 2015. w6 The Epstein-Barr virus is a ubiquitous herpesvirus, with more than 90% of the world’s population infected by adulthood. w7 The virus is one of our most effective parasites w8 and remains as a lifelong, latent infection, by integrating itself into the life cycle of healthy B lympho- cytes. 2 w9 There is persistent low grade replication and the virus is shed intermittently into pharyngeal secretions, particularly saliva, through which it is transmitted. w10 w11 Previous articles in this series Relapse in multiple sclerosis ( BMJ 2015;350:h1765) The management of acute testicular pain in children and adolescents ( BMJ 2015;350:h1563) Management of severe acute dental infections ( BMJ 2015;350:h1300) Sudden cardiac death in athletes ( BMJ 2015;350:h1218) Temporomandibular disorders ( BMJ 2015;350:h1154) Infectious mononucleosis characterised by enlarged atypical lymphocytes
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30 25 April 2015 | the  bmj EDUCATION CLINICAL REVIEW tious mononucleosis and at least a 50% lymphocytosis
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  • Fall '18
  • infectious mononucleosis, Herpesviridae

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