mononucleosis elderly

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...

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...

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)...

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...

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...

BACKGROUND: There is good evidence of reduced prescribing of antibiotics in recent years, but the reason for this has not been established. AIM: To study the incidence of respiratory tract infections presenting to general practitioners (GPs) in England and Wales in relation to the incidence of other infections and to the prescription of antibiotics. SETTING: Sentinel practices in England and Wales who contribute to the Weekly Returns Service (WRS) of the Royal College of General Practitioners...

During acute infection, latent and lytic Epstein-Barr virus (EBV) epitope-specific CD8(+) T cells have a CD45RO(+) CD45RA(-) phenotype. However, after resolution of the infection, a large proportion of these cells, particularly those specific for lytic viral epitopes, re-express the CD45RA molecule. The role of CD8(+) CD45RA(+) T cells in ongoing immunity to EBV and other viruses is unknown. We now demonstrate that, relative to their CD45RO(+) counterparts, the EBV-specific CD8(+) T cells that revert to CD45RA expression after acute infectious mononucleosis are not in cell cycle, have longer telomeres, and are more resistant to apoptosis partly because of increased Bcl-2 expression...

BACKGROUND: Infectious mononucleosis usually manifests in adolescents and young adults. Medical history in elderly patients is often atypical and severe. CASE REPORT: We report on the medical history of a 60-year-old woman, who came into our hospital with fever, icterus, decreasing performance status and abdominal pain. Splenomegaly and multiple abdominal lymph nodes could be found by ultrasound and CT scan. Endoscopically severe mucosal alterations could be found in the upper and lower gastrointestinal tract...

Infectious mononucleosis due to Epstein-Barr virus (EBV) is almost always a self-limited disease, most commonly seen in young adults. Hepatitis is a well-recognized complication of EBV infection that usually resolves spontaneously. Jaundice occasionally results from the unusual complication of autoimmune haemolytic anaemia rather than hepatitis. We report a 60-year-old man with severe cholestatic jaundice whose history, liver histology and laboratory findings suggested EBV infection. He also developed significant jaundice related to his hepatitis, but not to autoimmune haemolysis, a situation that led to diagnostic delay...

The authors determined the IgM and IgG anti-Epstein-Barr virus (EBV)-VCA and anti-EBNA levels in single serum samples of 1882 patients with diagnose except infectious mononucleosis. The serological results were divided into four groups according to different serological patterns: the seronegative group, the IgM anti-VCA positive group (supposedly having actual EBV infection), the IgG (only) anti-VCA group (probably recent EBV infection or not sufficiently functioning cellular immunity) and IgG anti-VCA antibodies together with anti-EBNA (past EBV infection)...

The authors detected Epstein-Barr virus (EBV) virus capsid (VCA) antibodies of IgM and IgG type together with EBNA and heterophil antibodies in the sera collected from 1882 unselected patients without infectious mononucleosis. Out of them IgM type antibodies were found in 123 cases and in an additional group of 30 patients heterophil antibodies were detected together with EBV specific virus markers. Altogether 153 patients were considered as cases of primary EBV infection, or reinfection. Comparing the distribution of age groups of the 1729 and the 153 patients, the author observed the increased incidence of elderly cases among patients with actual EBV infection, particularly above 60 years of age (P < 0...

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No abstract text is available yet for this article.

Three elderly patients are reported, in whom serologically confirmed recent infectious mononucleosis is followed by fatal lymphoproliferation (case 1), by acute monocytic leukemia (case 2), and by acute probably monocytic leukemia (case 3).

A patient aged 57 years with infectious mononucleosis and monoarthritis of the knee joint is described. To our knowledge, this association in elderly patients has not been reported heretofore, nor has the pathogenesis of arthritis in infectious mononucleosis been established. Because of the clinical picture and the synovial fluid findings, we suggest that the main mechanism of this arthritis is viral replication in the synovia.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Because the presentation and clinical features of infectious mononucleosis can be misleading in the elderly, a significant number of infections may go unrecognized. We report an unusual case of infectious mononucleosis in a 61-year-old man in whom marked visual impairment was the presenting complaint and severe optic neuritis was the only prominent finding. Confirmation of the diagnosis was made by serologic testing for Epstein-Barr virus antibody. Recovery of visual function was near complete, but optic atrophy persisted...

Clinical and laboratory features of 17 patients over 40 years of age (mean age: 55 years) admitted with infectious mononucleosis were compared with those of 17 adolescents (mean age: 13 years) hospitalized with this illness. Elderly patients with infectious mononucleosis were found to run a longer febrile course (13 vs. 7 days, p less than 0.01) and to have a lower peak total white blood cell count (6,600/mm3 vs. 11,000/mm3, p less than 0.001) and a lower incidence of splenomegaly (50% vs. 76%, p less than 0...

Orthogonal and forward light-scattering properties of lymphocytes were measured from patients with different lymphocytic diseases in order to determine the potential value of light scattering as a screening device. Monitoring of orthogonal light scattering of lymphocytes of a B-cell chronic lymphocytic leukemia patient during splenic irradiation (SI) revealed the selective decrease of malignant cells and the fact that the major part of the residual lymphocytes were cytotoxic lymphocytes. By combining forward and orthogonal light scattering it was shown that lymphocytes from a patient with T gamma lymphocytosis were abnormal...