ORCID
0000-0001-7274-2650
Department
Dept. of Biological Sciences, MTU, Cork
Year of Study
4
Full-time or Part-time Study
Part-time Study
Level
Postgraduate
Presentation Type
Poster
Supervisor
Dr Brigid Lucey
Abstract
The Epstein-Barr Virus (EBV) or human herpesvirus 4 (HHV-4) is the sole etiologic agent of the acute illness in humans described either as infectious mononucleosis (IM), or glandular fever. IM is a self-limiting disease with various but transient symptoms which include fever, fatigue, malaise, sore throat, swollen lymph glands (particularly of the neck), swollen liver and spleen. Diagnosis relies on clear, timely and informative laboratory test results. Patients with primary IM infection often present on investigation with a well-documented population of atypical/plasmacytoid lymphocytes. The qualitative detection of heterophile antibodies (HAs) is also a useful aid in the diagnosis of primary IM infections.
As the clinical signs and symptoms of IM overlap with several other infectious diseases and malignant states, a prompt diagnosis ensures appropriate treatment and management of the patient whilst also negating the need for other expensive exploratory tests in cases that present with splenomegaly, lymphadenopathy, or suspect haematological conditions.
Atypical cases can present a challenge for the clinician; the distinction of viral from bacterial throat infections is particularly important as mis-treatment with antibiotics can lead to the development of ampicillin rashes.
As there are currently no international guidelines on how this disease should be investigated, the aim of this work is to determine what markers/parameters can help streamline the investigative process and lead to a more informed diagnostic approach. Here we are looking at how the presence of atypical lymphocytes and the patients’ age can help direct the test protocol.
Keywords:
Epstein-Barr virus, Infectious Mononucleosis, Atypical lymphocytes, Antibodies, Haematology
Start Date
2-11-2023 11:15 AM
End Date
2-11-2023 12:00 PM
Recommended Citation
Naughton, Patrick, "How Irish medical scientists can assist in the improved diagnosis of disease - Infectious Mononucleosis (IM) a case in point" (2023). ORBioM (Open Research BioSciences Meeting). 6.
https://sword.cit.ie/orbiom/2023/posters/6
Included in
How Irish medical scientists can assist in the improved diagnosis of disease - Infectious Mononucleosis (IM) a case in point
The Epstein-Barr Virus (EBV) or human herpesvirus 4 (HHV-4) is the sole etiologic agent of the acute illness in humans described either as infectious mononucleosis (IM), or glandular fever. IM is a self-limiting disease with various but transient symptoms which include fever, fatigue, malaise, sore throat, swollen lymph glands (particularly of the neck), swollen liver and spleen. Diagnosis relies on clear, timely and informative laboratory test results. Patients with primary IM infection often present on investigation with a well-documented population of atypical/plasmacytoid lymphocytes. The qualitative detection of heterophile antibodies (HAs) is also a useful aid in the diagnosis of primary IM infections.
As the clinical signs and symptoms of IM overlap with several other infectious diseases and malignant states, a prompt diagnosis ensures appropriate treatment and management of the patient whilst also negating the need for other expensive exploratory tests in cases that present with splenomegaly, lymphadenopathy, or suspect haematological conditions.
Atypical cases can present a challenge for the clinician; the distinction of viral from bacterial throat infections is particularly important as mis-treatment with antibiotics can lead to the development of ampicillin rashes.
As there are currently no international guidelines on how this disease should be investigated, the aim of this work is to determine what markers/parameters can help streamline the investigative process and lead to a more informed diagnostic approach. Here we are looking at how the presence of atypical lymphocytes and the patients’ age can help direct the test protocol.
Comments
The Monospot test detects increased levels of HAs and is a quick and inexpensive way of confirming a diagnosis of IM when seen in conjunction with a tell-tale population of atypical lymphocytes. Although the initial FBC analysis may show lymphocytosis, it is the peripheral blood film examination that distinguishes the atypical lymphocytes associated with the disease. This study suggests that Monospot tests should be delayed until after peripheral blood examination and the detection and reporting of atypical lymphocytes; the patient's age should also be a factor before testing given the increased EBV seroprevalence, particularly in the 40+ age group. Further analysis of the laboratory data, including a prospective analysis, could potentially guide the establishment of an international standard or algorithm for the testing of this disease. This would go some way to verifying or discounting some of the present findings relating to this disease and potentially lead to a more standardized approach in the testing and diagnosis of this disease in the future.