单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Infectious Mononucleosis(IM)mono,Huang Yanfeng,associate professor,DIVISION OF INFECTIOUS DISEASE OF CHONGQING MEDICAL UNIVERSITY,Infectious Mononucleosis(IM),1,Introduction,Infectious mononucleosis(IM)is an infectious disease caused by Epstein-Barr virus(EBV).,The clinical features include fever,pharyngitis,and generalized lymphadenopathy.,The characteristics of lab study is atypical lymphocytosis in the peripheral blood.,IntroductionInfectious mononuc,2,EBV associated disease,The upper respiratory tract infection,Infectious mononucleosis(IM),EB Virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH),Chronic active EBV infection,EB Virus-associated malignant tumor,(Burkitt lymphoma、B cell lymphoma、Hodgkins disease,nasopharyngeal carcinoma),EBV associated disease The upp,3,(儿科学英文ppt课件)20-传染性单核细胞增多症,4,(儿科学英文ppt课件)20-传染性单核细胞增多症,5,Etiology,3、,Viral Antigen Systems,viral capsid antigen,VCA,EB nuclear antigen,EBNA,early antigen,EA,lymphocyte-detected membrane antigen,LYDMA,membrane antigen,MA,Etiology3、Viral Antigen System,6,Epidemiology,1.Infectious sources,Patients,persons with latent infection and carriers,2.,Routes of transmission,：,Contact transmission through the mouth,(exchange of saliva),blood transmission occasionally,3.,Population susceptibility,School age children and,adolescents,4.Epidemiological features,Peak seasons,Epidemiological status,Epidemiology1.Infectious sour,7,传染性单核细胞增多症及其相关疾病临床特点分析,中国实用儿科杂志,2003年12月第18卷12期,儿童传染性单核细胞增多症临床特点与发病年龄的关系附312例临床分析,临床儿科杂志,2011年6月第29卷6期,6岁以下232例，占74.4%，6-15岁80例，占25.6%,传染性单核细胞增多症及其相关疾病临床特点分析,中国实用儿科杂,8,重庆医科大学感染消化教研室,重庆医科大学感染消化教研室,9,Epidemiology,1.Infectious sources,Patients,persons with latent infection and carriers,2.,Routes of transmission,：,Contact transmission through the mouth,(exchange of saliva),blood transmission occasionally,3.,Population susceptibility,School age children and,adolescents,4.Epidemiological features,Peak seasons,Epidemiological status,Epidemiology1.Infectious sour,10,Pathogenesis,EBV,salivary glands,infects oral epithelial cells and B-LC in pharynx,pharyngitis,Lymphadenopathy,in cervical nodes,excrete EBV,Continuously or,intermittently,B-LC in the peripheral blood and the entire lymphoreticular system,viremia,Activation of polyclonal B-LC,polyclonal antibodies,Specific Abs,heterophil Ab,autoantibody,Tc,responsed to the infected B-LC,Effect on B-LC containing EBV,atypical LC,Hepatosplenomegaly,lymphadenectasis,myocarditis,pneumonia,etc.,Changes of antigenicity on the surface of B-LC,TCL,PathogenesisEBV salivary gland,11,Pathology,The basic pathological change is,the,benign lymphadenosis,The main damage is in,monocyte-macrophage system,Lymph nodes,：non-,pyogenic,lymphadenectasis with,LC and,monocyte-macrophage system,proliferation,Spleen:lots of atypical LC,LC infiltration and l,imited necrotic lesions in organs such as liver,heart,kidney,lung,CNS,etc.,PathologyThe basic pathologica,12,Manifestations,The incubation period,：515 days,1.,Fever,(90%),2.,pharyngitis,:,80%.,sore throat,tonsillar enlargement,hyperemia,edema,and,exudates,（50%）,3.generalized,lymphadenopathy,：,80100%.,The most common,lymphadenopathy,is,enlargement of cervical lymph nodes,4.splenohepatomegalia,:,hepatomegaly,：,3050%.,Among them,2/3 has,elevated liver enzymes,Jaundice is uncommon.,Liver failure may occurred in few cases.,splenomegaly,：,5070%,5.rashes,：10%,6.others,：stuff nose,snore,edema of the eyelids,etc,ManifestationsThe incubation p,13,The tonsils are hyperemic and edematous covered with gray-white exudates.,The tonsils are hyperemic and,14,(儿科学英文ppt课件)20-传染性单核细胞增多症,15,Manifestations,The incubation period,：515 days,1.,Fever,(90%),2.,pharyngitis,:,80%.,sore throat,tonsillar enlargement,hyperemia,edema,and,exudates,（50%）,3.generalized,lymphadenopathy,：,80100%.,The most common,lymphadenopathy,is,enlargement of cervical lymph nodes,4.splenohepatomegalia,:,hepatomegaly,：,3050%.,Among them,2/3 has,elevated liver enzymes,Jaundice is uncommon.,Liver failure may occurred in few cases.,splenomegaly,：,5070%,5.rashes,：10%,6.others,：stuff nose,snore,edema of the eyelids,etc,ManifestationsThe incubation p,16,cervical lymph nodes,17,cervical lymph nodes,cervical lymph nodes,18,Manifestations,The incubation period,：515 days,1.,Fever,(90%),2.,pharyngitis,:,80%.,sore throat,tonsillar enlargement,hyperemia,edema,and,exudates,（50%）,3.generalized,lymphadenopathy,：,80100%.,The most common,lymphadenopathy,is,enlargement of cervical lymph nodes,4.splenohepatomegalia,:,hepatomegaly,：,3050%.,Among them,2/3 has,elevated liver enzymes,Jaundice is uncommon.,Liver failure may occurred in few cases.,splenomegaly,：,5070%,5.rashes,：10%,6.others,：stuff nose,snore,edema of the eyelids,etc,ManifestationsThe incubation p,19,临床表现,临床表现,20,(儿科学英文ppt课件)20-传染性单核细胞增多症,21,文献资料,传染性单核细胞增多症及其相关疾病临床特点分析,中国实用儿科杂志,2006年9月第21卷9期,文献资料,22,病例学习,患儿，女，6岁,因”发热、咽痛6天，颈部包块4天”入院。6天前开始发热,体温可达39.8，无畏寒，寒战，诉咽痛，吞咽时明显。2天后家人发现颈部包块，不伴疼痛。轻咳，鼻阻明显，打鼾。精神食欲尚可。院外予头孢菌素（不详）治疗4天，无明显好转。无类似病人接触史。查