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mononucleosis elderly

Kohei Kano, Takayuki Katayama, Shiori Takeguchi, Asuka Asanome, Kae Takahashi, Tsukasa Saito, Jun Sawada, Masato Saito, Ryogo Anei, Kyousuke Kamada, Naoyuki Miyokawa, Hiroshi Nishihara, Naoyuki Hasebe
A 75-year-old woman was admitted to our hospital with rapidly deteriorating consciousness disturbance. She had a 7-year history of rheumatoid arthritis (RA), which had been treated with methotrexate (MTX) and prednisolone. Brain T2-weighted MRI showed diffuse high-intensity lesions in the cerebral subcortical and deep white matter, bilateral basal ganglia and thalamus. A cerebrospinal fluid examination revealed elevated protein levels and positive Epstein-Barr virus (EBV) DNA. Human immunodeficiency virus was negative...
June 2017: Neuropathology: Official Journal of the Japanese Society of Neuropathology
Burke A Cunha, John Gian
BACKGROUND: Hospitalized adults with fever and "pneumonia" can be a difficult diagnostic challenge particularly when the clinical findings may be due to different infectious diseases. METHODS: We recently had an elderly female who presented with fever, fatigue and dry cough with elevated serum transaminases and lung infiltrates. The diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (IM) was made based on a positive Monospot test, elevated EBV VCA IgM titer, and highly elevated EBV viral load...
November 2016: Heart & Lung: the Journal of Critical Care
Nawid M Sarwari, Joseph D Khoury, Cristhiam M Rojas Hernandez
BACKGROUND: Chronic Epstein Barr virus (EBV) infection in an immunocompetent host has been described however it is not a common entity. It has been linked to many lymphoproliferative disorders and achieves such via many molecular mechanisms, some of which are poorly understood. In addition to infectious mononucleosis, the EBV is linked to various other hematological pathologies and autoimmune disorders. CASE PRESENTATION: We describe the case of an elderly immunocompetent female who presented with non-specific symptomatology, lymphadenopathy, cytopenias, elevated autoantibody titers and a crescent EBV viral load that were suggestive of a multisystemic inflammatory disease related to EBV...
2016: BMC Hematology
Jorge J Castillo, Brady E Beltran, Roberto N Miranda, Ken H Young, Julio C Chavez, Eduardo M Sotomayor
Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) of the elderly is a provisional entity included in the 2008 WHO classification of lymphoid neoplasms. It is a disease typically seen in the elderly and thought to be associated with chronic EBV infection and severe immunosuppression with a component of immunosenescence. Recent research, however, has suggested that EBV-positive DLBCL can be seen in younger, immunocompetent patients. The diagnosis of EBV-positive DLBCL of the elderly is made through a careful pathological evaluation...
May 2016: American Journal of Hematology
Natanong Thamcharoen, Suthanya Sornprom, Nitipong Permpalung, Charles L Hyman
A 75-year-old woman presented with altered mental status, septic picture, and influenza-like symptoms. Initial investigations revealed atypical lymphocytosis, thrombocytopenia, elevated liver enzymes, and a positive monospot test result. Further investigation showed the Epstein-Barr virus viral capsid antibody IgM/IgG and Epstein-Barr virus DNA by polymerase chain reaction to be negative; however, interestingly her cytomegalovirus (CMV) IgM and IgG were positive, suggesting that her mononucleosis-like syndrome was due to acute CMV infection...
October 2015: American Journal of Emergency Medicine
Toshihisa Hamada, Shigeo Nakamura, Young-Hyeh Ko, Tadashi Yoshino, Koichi Ohshima, Takamitsu Matsuzawa, Keiko Miura, Toshifumi Takahashi, Hisashi Nomura, Tomomi Hoshino, Daisuke Suzuki, Shinji Shimada, Keiji Iwatsuki
From a clinicopathological conference on nine elderly patients with Epstein-Barr virus (EBV)-associated T/natural killer (NK)-cell lymphoma, we have addressed the patients' backgrounds, clinical manifestations, histopathological findings, cytogenesis, complications and prognoses. Among these elderly patients (>65 years old), seven patients had extranodal NK/T-cell lymphoma, nasal type (ENKL) with an NK-cell phenotype, and two patients had EBV(+) T-cell lymphomas or lymphoproliferative disorders (LPD) with cutaneous lesions mimicking pityriasis lichenoides et varioliformis acuta (PLEVA) or hydroa vacciniforme (HV)...
January 2014: Journal of Dermatology
Syed H Hussaini, Nicola Pilkington, John N Barnes
We describe a case of infectious mononucleosis (IM) hepatitis occurring in an elderly thespian, who had recently played the role of 'Father Christmas'. We discuss the importance of differing clinical manifestations in older and younger age groups, the changing epidemiology of Epstein Barr (EB) infection within the United Kingdom and the role of different virology tests in establishing a diagnosis. Raised awareness of this changing pattern of disease could prevent unnecessary investigation and consequent potential iatrogenic complications...
2013: Acute Medicine
Hani M Babiker, Troy Wiedenbeck, Ryan S Robetorye, Utkarsh Acharya, Susan Wilansky, Shimon Kusne
Primary Epstein-Barr virus (EBV) infection occurs mainly in adolescents and young adults, with more than 90% of adults having serological evidence of past infection. Primary infection in those over the age of 40 is associated with an atypical and often more severe presentation that can lead to more extensive and invasive, and often unnecessary, diagnostic testing. The incidence of severe EBV-related illness in older adults has been observed to be increasing in industrialized nations. The characteristic presentation of infectious mononucleosis (IM) syndrome in elderly patients (age > 65) is not clearly defined in the literature...
2013: Case Reports in Medicine
Ekta Gupta, Vikram Bhatia, Aashish Choudhary, Archana Rastogi, Naveen L Gupta
Epstein-Barr virus (EBV) is the causative agent of infectious mononucleosis (IM) which is characterized by the triad of fever, sore throat, and lymphadenopathy. Self-limited, mild liver function test abnormalities are seen in IM. Acute hepatitis in primary EBV infection is uncommon. Serum transaminases are elevated but are less than fivefold the normal levels in most cases and rarely exceed 10 times the normal levels in primary EBV infections especially in elderly. Laboratory diagnosis of acute EBV infection is by serological assays confirming the presence of EBV viral capsid antigen (VCA) IgM antibodies...
March 2013: Journal of Medical Virology
Christina Orasch, Anna Conen
Primary cytomegalovirus (CMV) infection is rare in immunocompetent adults, even rarer in elderly patients. Little is known about the severity of symptoms and the clinical course in this patient group. In children and younger adults, CMV mostly presents as an asymptomatic disease or a self-limiting mild mononucleosis-like syndrome. We describe the clinical course of an unusually severe primary CMV infection in a 69-y-old otherwise healthy man, as well as 6 other severe cases in immunocompetent adults at our institution, and compare them to adult cases from the literature...
December 2012: Scandinavian Journal of Infectious Diseases
Burke A Cunha, Andrew Petelin, Sonia George
We describe fever of unknown origin (FUO) in a 57-year-old woman with hepatosplenomegaly. The diagnostic workup was directed at diagnosing a lymphoma. Her history of travel and exposures to food and water did not make typhoid fever a likely diagnostic possibility. Because she presented with prolonged fevers, fatigue, anorexia, weight loss, and night sweats with hepatosplenomegaly, lymphoma was likely. Initially, Epstein-Barr virus (EBV) was not considered because of her age, the absence of pharyngitis and cervical adenopathy, and the higher likelihood of another diagnosis, ie, lymphoma...
January 2013: Heart & Lung: the Journal of Critical Care
L J Vine, K Shepherd, J G Hunter, R Madden, C Thornton, V Ellis, R P Bendall, H R Dalton
BACKGROUND: Abnormal liver blood tests are common in Epstein-Barr virus (EBV) infection, but symptomatic hepatitis is rare. The demographics, clinical features and outcome of EBV hepatitis are incompletely understood, particularly in the elderly people. AIM: To identify the demographics, presenting features and natural history of EBV hepatitis. METHODS: Retrospective review of 1995 consecutive patients attending the jaundice hotline clinic over a 13-year period...
July 2012: Alimentary Pharmacology & Therapeutics
Xi Yang, Jing Wang, Yun-fei An, Hirokazu Kanegane, Toshio Miyawaki, Xiao-dong Zhao
OBJECTIVE: X-linked lymphoproliferative disease (XLP), a genetic disorder characterized by immunodeficiency to Epstein-Barr virus (EBV) infection, has been linked to mutations in the SH2D1A gene. XLP patient displays EBV associated fulminant infectious mononucleosis or hemophagocytic lymphohistocytosis, hypogammaglobulinemia or malignant lymphoma. Here we report the clinical features, gene mutation and SAP expression on PBMCs of a Chinese patient with XLP and potential carriers. METHOD: A 6 years old male patient and his maternal relatives were enrolled in this study...
June 2011: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Burke A Cunha, Jean E Hage, Yelda Nouri
BACKGROUND: Fever of unknown origin (FUO) has been defined as a fever of ≥101°F that persists for 3 weeks or more. It is not readily diagnosed after 1 week of intensive in-hospital testing or after intensive outpatient or inpatient testing. Fevers of unknown origin may be caused by infectious diseases, malignancies, collagen vascular diseases, or a variety of miscellaneous disorders. The relative distribution of causes of FUOs is partly age-related. In the elderly, the preponderance of FUOs is attributable to neoplastic and infectious etiologies, whereas in children, collagen vascular diseases, neoplasms, and viral infectious disease predominate...
March 2012: Heart & Lung: the Journal of Critical Care
Jun Nishikawa, Hisashi Funada, Takako Miyazaki, Haruka Fujinami, Takayoshi Miyazono, Jun Murakami, Takahiko Kudo, Toshiro Sugiyama
Infectious mononucleosis (IM) is a clinical syndrome caused by primary infection with Epstein-Barr virus (EBV) that is common in adolescents. In adults, particularly in elderly people, the clinical picture of IM tends to be atypical, often leading to a diagnostic challenge. Diagnosis is also complicated because infection with EBV can induce the synthesis of cross-reacting immunoglobulin M antibodies for other herpesviruses. We report an unusual case of infectious mononucleosis in a 34-year-old immunocompetent adult...
October 2011: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Rakesh K Goyal, Dimple Srivastava, Klaus-Dieter Lessnau
In patients undergoing percutaneous coronary intervention and in those with acute coronary syndromes, clopidogrel plus aspirin is the first-line antiplatelet therapy for reducing cardiovascular events. Although clopidogrel is generally well tolerated, with rash, indigestion, vomiting, diarrhea, and bleeding being the most common adverse effects, rare but serious complications may occur. We describe a 78-year-old woman who underwent percutaneous coronary intervention with drug-eluting stents; clopidogrel and aspirin were started as antiplatelet therapy...
May 2009: Pharmacotherapy
Masaru Kojima, Makoto Kashimura, Hideaki Itoh, Akihiro Noro, Bunshiro Akikusa, Misa Iijima, Kazuhiko Shimizu, Nobuhide Masawa, Shigeo Nakamura
We report six cases of Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (LPDs) in middle-aged and elderly patients exhibiting atypical clinical findings. The patients, two males and four females, ranged in age from 52 to 74 years, with a median age of 64 years. Clinically, they were characterized by tonsillar tumor, cervical lymphadenopathy, and absence of atypical lymphocytosis of the peripheral blood. "B"symptoms were recorded in only two cases. Pancytopenia was recorded in one case during the disease course...
2007: Pathology, Research and Practice
Yan Zhang, Diana L Wallace, Catherine M de Lara, Hala Ghattas, Becca Asquith, Andrew Worth, George E Griffin, Graham P Taylor, David F Tough, Peter C L Beverley, Derek C Macallan
Human natural killer (NK) cells form a circulating population in a state of dynamic homeostasis. We investigated NK cell homeostasis by labelling dividing cells in vivo using deuterium-enriched glucose in young and elderly healthy subjects and patients with viral infection. Following a 24-hr intravenous infusion of 6,6-D(2)-glucose, CD3(-) CD16(+) NK cells sorted from peripheral blood mononuclear cells (PBMC) by fluorescence-activated cell sorter (FACS) were analysed for DNA deuterium content by gas chromatography mass spectrometry to yield minimum estimates for proliferation rate (p)...
June 2007: Immunology
M S Duh, A M Walker, K H Kronlund
OBJECTIVES: This study quantifies the incidence of liver enzyme abnormalities in the general population of central Massachusetts. METHODS: Computerized data files from a health maintenance organization were used to ascertain potential subjects during the study period of 1 July 1992-30 June 1993. Medical records and laboratory tests results were reviewed to confirm the diagnoses. RESULTS: The incidence rates were 40.6 cases per 100,000 persons per year for drug-associated liver enzyme abnormalities, 39...
July 1999: Pharmacoepidemiology and Drug Safety
G Karachalios, A K Charalabopoulos, I G Karachaliou, K Charalabopoulos
Infectious mononucleosis (IM) is a benign disease and is frequently associated with mild respiratory symptoms. The pulmonary manifestations rarely dominate the clinical picture. We report a case of an older adult patient with IM who developed diffuse pneumonia and acute respiratory failure. The diagnosis of IM was confirmed serologically, whereas other possible causes of pneumonia were excluded in this study. Pulmonary manifestations of IM are discussed, and the atypical features that may be seen in older adults are simultaneously reviewed...
January 2004: International Journal of Clinical Practice
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