Infectious Mononucleosis: EBV and CMV Overview
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Questions and Answers

What is a potential consequence of primary CMV infection in pregnant women?

  • Cure of pre-existing infections
  • Immediate maternal death
  • Increased immunity to all viral infections
  • Development of birth defects (correct)

    • Which of the following is NOT a common transmission route for CMV?

  • Casual contact with infected individuals (correct)
  • Saliva in early childhood
  • Semen in young adults
  • In utero

    • What clinical finding is associated with immunocompetent individuals infected with CMV for the first time?

  • High fever with rash
  • Heterophile antibody positive
  • Abnormal lymphocytes in peripheral blood (correct)
  • Coughing and wheezing

    • Which of the following laboratory techniques is used to diagnose CMV?

    <p>Histological evidence of inclusion bodies</p> Signup and view all the answers

    What is a commonly observed characteristic in laboratory findings of CMV?

    <p>Owl's eye appearance in giant cells</p> Signup and view all the answers

    What is the primary complaint of individuals suffering from infectious mononucleosis?

    <p>Fatigue</p> Signup and view all the answers

    Which antibodies are indicative of an acute EBV infection?

    <p>IgM</p> Signup and view all the answers

    What is a potential consequence of continued B-cell proliferation in the context of EBV infection?

    <p>Development of lymphoma</p> Signup and view all the answers

    Which of the following is NOT a characteristic of CMV-related mononucleosis?

    <p>Causes high fever</p> Signup and view all the answers

    In patients with AIDS, which type of cancer is associated with increased risk due to EBV?

    <p>Burkitt's lymphoma</p> Signup and view all the answers

    What is the diagnostic method used to identify atypical lymphocytes in infectious mononucleosis?

    <p>Blood smear</p> Signup and view all the answers

    What is a common geographical association of EBV-related neoplasms?

    <p>Certain regions of Africa</p> Signup and view all the answers

    What is the recommended approach for treating uncomplicated infectious mononucleosis?

    <p>No specific treatment necessary</p> Signup and view all the answers

    What type of virus is Epstein-Barr virus categorized as?

    <p>Gammaherpesvirus</p> Signup and view all the answers

    Which cells are primarily infected by Epstein-Barr virus?

    <p>B-lymphocytes</p> Signup and view all the answers

    What is a significant characteristic of herpesviruses?

    <p>They can establish latent infections.</p> Signup and view all the answers

    Which receptor is primarily used by Epstein-Barr virus to attach to cells?

    <p>CR2 (CD21)</p> Signup and view all the answers

    How is Epstein-Barr virus transmitted?

    <p>Saliva sharing</p> Signup and view all the answers

    What type of antibodies are produced during a B-cell proliferation caused by Epstein-Barr virus infection?

    <p>IgM antibodies</p> Signup and view all the answers

    What characteristic do most herpesviruses share regarding their genome?

    <p>DNA genome</p> Signup and view all the answers

    Which antibody is associated with the agglutination of sheep and horse red blood cells during Epstein-Barr virus infection?

    <p>Heterophile antibody</p> Signup and view all the answers

    Study Notes

    Infectious Mononucleosis (EBV and CMV)

    • Infectious mononucleosis (IM) is a viral illness.
    • EBV and CMV are viruses causing IM.
    • IM is prevalent in the US, with at least 70% of the population infected by EBV by age 30.
    • EBV is transmitted through saliva ("kissing disease").
    • Productive infection of B cells and oropharyngeal epithelial cells (e.g., tonsils) from EBV leads to virus shedding in saliva.
    • Children generally have mild or asymptomatic IM, and older individuals may show varying degrees of severity.
    • Acyclovir has little direct impact on EBV.

    Objectives

    • Students can identify the microbiological features of EBV and CMV.
    • Students can outline the life cycle of EBV and CMV.
    • Students can recognize the clinical features of EBV and CMV infections.
    • Students can identify laboratory methods to diagnose EBV and CMV infections.

    Herpesviridae

    • Herpeviruses are enveloped, icosahedral nucleocapsids.
    • They are DNA viruses.
    • Many types exhibit latency and recurrent infections.
    • Herpesviruses are quite sensitive to acid solvents, detergents, and drying.
    • Cell-mediated immunity is critical to controlling herpes infections and associated symptoms.

    Families of DNA Viruses

    • The presentation classifies virus families by various characteristics.
    • These characteristics include structure (naked/enveloped, helical/icosahedral, complex), DNA type (single-stranded, double-stranded, linear, circular, gapped), and size (in nm).

    Table I-5-7. DNA Viruses

    • The table characterizes DNA viruses by their:
      • DNA type
      • Virion-Associated Polymerase
      • Envelope
      • Location of DNA replication

    CMV- a Betaherpesvirus

    • CMV causes heterophile antibody-negative mononucleosis (not associated with the typical heterophile antibody response in EBV IM).
    • CMV is a common infection in those with normal immune systems.
    • CMV infections may cause serious issues in babies due to primary infections as a pregnant woman.
    • Symptoms may include jaundice and hepatosplenomegaly.
    • CMV is a TORCH pathogen.
    • CMV can cause pneumonia and retinitis in immunocompromised individuals.
    • CMV latency occurs in monocytes .
    • Reactivation can lead to urine shedding.
    • CMV transmission can occur from toddlers to other toddlers in daycare through saliva and urine.

    Transmission of CMV

    • CMV transmission can occur through several routes, including:
      • In utero (from mother to baby)
      • Through urine
      • In early childhood (via saliva, etc.)
      • Through sexual contact in adults
      • By blood transplantation
      • By organ transplantation
    • These routes demonstrate the many potential modes of CMV transmission.

    Primary Infection of a Pregnant Woman with CMV

    • The presentation highlights that CMV infections in pregnant women may lead to birth defects in their babies.

    Clinical Findings in CMV

    • Common birth defects associated with CMV include microcephaly and purpura (a rash).
    • CMV can cause a range of clinical symptoms, depending on the immune status of the affected individual.

    CMV

    • The presentation provides prevalence data for CMV.
    • CMV prevalence data highlights the frequency of CMV infections.

    Prevention and Precautions

    • The presentation includes recommendations for preventing CMV transmission, especially in day-care settings or among people who are pregnant, or have young children.
    • The recommendations often involve hygiene practices such as frequent handwashing and avoiding contact with bodily fluids, including saliva.

    Diagnosis

    • EBV and CMV Diagnosis:
      • Diagnosis involves blood smears to detect abnormal lymphocytes (especially the atypical lymphocytes called Downey cells).
      • Monospot or Elisa tests for heterophile antibodies are crucial for distinguishing EBV from CMV infections.
      • EBV-specific antibodies indicate whether an infection is active, past, or chronic.
      • Testing for antibodies is critical for identifying the presence of CMV infection and its type (acute, chronic, or past).

    Treatment

    • There's no vaccine for CMV or EBV.
    • The treatment for IM, whether caused by EBV or CMV, is often focused on symptom management and supporting the immune system.
    • Specific antiviral drugs and Immunoglobulins can be used for cases in immunocompromised individuals.

    Immunocompetent and Immunosuppressed Individuals Infected with CMV or EBV

    • The presentation differentiates the clinical manifestation of EBV and CMV infection based on the patient's immune status.
    • Immunocompetent individuals typically present with IM, heterophile antibody-positive case, and sometimes additional symptoms.
    • Immunosuppressed individuals may have more extensive or serious complications arising from CMV infection involving many organs.

    Laboratory Diagnosis

    • The presentation provides a method to remember the results of a monospot test. It includes whether it is a positive or a negative response for EBV or CMV.

    Additional Notes

    • The presentation covers various aspects of infectious mononucleosis, caused by EBV or CMV.
    • It covers different characteristics, transmission, diagnosis, and treatment approaches.
    • The presentation also highlights the importance of prevention strategies, especially for pregnant women to reduce risks to their children.

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    Infectious Mononucleosis - EBV and CMV (PDF)

    Description

    This quiz covers the fundamentals of infectious mononucleosis caused by Epstein-Barr Virus (EBV) and Cytomegalovirus (CMV). It includes microbiological features, life cycles, clinical manifestations, and diagnostic methods associated with these viral infections. Perfect for students looking to enhance their understanding of IM and its causative agents.

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