Disease: Infectious mononucleosis (IM), Burkitt’s lymphoma (BL), undifferentiated nasopharyngeal carcinoma (NPC).

Etiologic Agent: Epstein-Barr virus—etiologic in IM; cofactor in BL and NPC.

Source: Human saliva and blood.

Clinical Manifestations: Acute or insidious onset with fever, pharyngitis, lymphadenopathy. May be associated with varying degrees of splenomegaly, hepatomegaly, or frank hepatitis. Rare central nervous system involvement.

Pathology: Marked lymphocytosis involving most of the lymphoreticular tissues; hematologic abnormalities include >10,000 lymphocytes/ml with >10 to 15% atypical lymphocytes; elevated liver enzymes.

Laboratory Diagnosis: Positive Paul-Bunnell heterophile antibodies within the first 4 weeks of illness in adolescent and older patients. EBV serology may be needed for hetero- phile-negative patients; EBV isolation not useful.

Epidemiology: Worldwide; infections mostly asymptomatic in children; morbidity in-creases with age of primary infection; infections occur in children younger than 5 years of age in lower socioeconomic communities; acute disease is mostly sporadic with no seasonal variation among older patients in more affluent communities.

Treatment: Anecdotal report of efficacy with acyclovir and its derivatives. Prevention and Control: Avoidance of salivary exchange.


Infectious Mononucleosis Heterophile Antibody Lymphoblastoid Line 
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© Springer-Verlag New York Inc. 1988

Authors and Affiliations

  • Evelyne T. Lennette

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