Epstein-Barr virus (EBV) is a widely disseminated herpesvirus that is spread by close contact between susceptible persons and asymptomatic EBV shedders. EBV is the primary agent of infectious mononucleosis (IM) and is associated with the development of B cell lymphoma, T cell lymphoma, Hodgkin lymphoma, and nasopharyngeal carcinoma.
●Subclinical infection − Most primary EBV infections throughout the world are subclinical and inapparent.
●Infectious mononucleosis − Infectious mononucleosis (IM) usually begins with malaise, headache, and low-grade fever before onset of more specific signs of the infection, such as pharyngitis and cervical lymph node enlargement. Patients usually have a peripheral blood lymphocytosis, with atypical lymphocytes.
●Primary infection in infants and children − Primary EBV infections in young infants and children are common but are frequently asymptomatic. When symptoms do occur, a variety of manifestations have been observed, including otitis media, diarrhea, abdominal complaints, upper respiratory infection, and symptoms and signs consistent with infectious mononucleosis.
●Congenital and perinatal infections − Intrauterine infection with EBV is rare because fewer than 5 percent of pregnant women are susceptible to the virus. In addition, congenital abnormalities have not been documented among infants of women who did develop primary EBV infection during pregnancy.
●Complications − EBV infection is associated with a number of acute complications and, in certain hosts, more delayed effects. As examples:
•Morbilliform rashes sometimes follow the administration of ampicillin in a patient with IM. The mechanism responsible for this rash is not understood.
•Splenic rupture is a rare but potentially life-threatening complication of IM and may be the first manifestation of IM that brings the patient to medical attention.
•Oral hairy leukoplakia is described as white, corrugated, painless plaques that usually affect the lateral portions of the tongue among patients with advanced HIV infection.
•EBV infection is associated with a variety of lymphoproliferative disorders. More than a dozen single gene mutations causing primary immune deficiency disorders are associated with severe EBV-induced disease.
●Supportive care − The mainstay of treatment for patients with infectious mononucleosis and other manifestations of primary EBV disease is supportive care.
