Clinical and laboratory evaluation of elderly patients with heterophil-antibody positive infectious mononucleosis

Horwitz, Charles A.; Henle, Werner; Henle, Gertrude; Segal, Marvin; Arnold, Thomas D.; Lewis, F; Zanick, D.; Ward, Patrick C. J.

doi:10.1016/0002-9343(76)90369-7

Cited by 53 publications

(6 citation statements)

References 27 publications

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“…28 Acute infection of EBV for young children is usually either asymptomatic or expressed by mild upper respiratory tract symptoms, while for older patients (aged greater than 40 years), pharyngitis and cervical lymphadenopathy are less frequent myalgia is prominent. 29,30 However, there were not enough prospective cohort studies for IM diagnosis in older adults; therefore, we did not conduct a stratified meta-analysis on the symptoms and signs based on the different age groups.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Signs, Symptoms, and Hematologic Parameters for the Diagnosis of Infectious Mononucleosis: A Systematic Review and Meta-Analysis

2021

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Section: Discussionmentioning

confidence: 99%

Accuracy of Signs, Symptoms, and Hematologic Parameters for the Diagnosis of Infectious Mononucleosis: A Systematic Review and Meta-Analysis

2021

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“…Indeed, only a limited number of viruses such as cytomegalovirus, Epstein Barr virus, and human immunodeficiency virus may cause FUO 14,18 . Cytomegalovirus and Epstein Barr virus infection are typical diseases of children, adolescents, and young adults, but it should not be forgotten that mononucleosis occurs in elderly patients, too 19–22 . Human immunodeficiency virus infection is primarily a disease of young sexually active people and is rarely found in the elderly population 23…”

Section: Discussionmentioning

confidence: 99%

Fever of Unknown Origin in Elderly Patients

Knockaert

Vanneste

Bobbaers

1993

J American Geriatrics Society

160

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Objective: To describe the spectrum of diseases that may give rise to fever of unknown origin in elderly patients and to delineate the diagnostic approach in these patients. Design: Subgroup analysis of a prospectively collected case series followed more than 2 years. Setting: General Internal Medicine Service based at University hospital, Leuven, Belgium. Patients: Forty‐seven consecutive patients, older than 65 years, meeting the classic criteria of fever of unknown origin. Measurements: The final diagnosis established and the clinical value of diagnostic procedures. Results: Infections, tumors and multisystem diseases (encompassing rheumatic diseases, connective tissue disorders, vasculitis including temporal arteritis, polymyalgia rheumatica, and sarcoidosis) were found in 12 (25%), six (12%) and 15 patients (31%), respectively. Drug‐related fever was the cause in three patients (6%), miscellaneous conditions were found in five patients (10%), and six patients (12%) remained undiagnosed. Microbiologic investigations were diagnostic in eight cases (16%), serologic tests yielded one diagnosis, immunologic investigations had a diagnostic value in four cases, standard X‐rays yielded a diagnostic contribution in 10 cases, ultrasonography and computed tomography were diagnostic in 11 cases, Gallium scintigraphy had a diagnostic contribution in 17 cases, and biopsies yielded the final diagnosis in 18 cases. Conclusions: Multisystem diseases emerged as the most frequent cause of fever of unknown origin in the elderly, and temporal arteritis was the most frequent specific diagnosis. Infections, particularly tuberculosis, remain an important group. The percentage of tumors was higher in our elderly patients than in the younger ones but still clearly lower than in other recent series of FUO in adults. The number of undiagnosed cases was significantly lower in elderly patients than in younger individuals (P ≤ 0.01). The investigation of elderly patients with FUO should encompass routine temporal artery biopsy and extensive search for tuberculosis if the classic tests such as blood count, chemistry, urinalysis, cultures, chest X‐rays, and abdominal ultrasonography do not yield any clue. Gallium scintigraphy should be considered as the next step and not as a last‐resort procedure.

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“…Herpes zoster is a common condition with a cumulative lifetime incidence of 20-30% with most of the risk concentrated in older age. The overall incidence is 1.2-3.4 per 1,000 personyears, but rates rise sharply with increasing age to 11.8 per 1,00,0 for persons age 65 years and older (67) . Chapter "Herpes Zoster" is devoted to the topic of herpes zoster, and the reader is referred to this section for further details.…”

Section: Varicella Zostermentioning

confidence: 96%

Viral Infections

Duncan

Falsey

2009

Infectious Disease in the Aging

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Although influenza remains indisputably the most significant viral pathogen in adults, other viruses such as respiratory syncytial virus, parainfluenza viruses, and human metapneumovirus are now recognized as significant pathogens in older populations.• Oseltamivir and zanamivir are antiviral agents that are effective for the treatment and prophylaxis of influenza A and B. For treatment and for optimal effect, therapy should be initiated within 48 h of symptom onset. • Infection with hepatitis viruses may be more severe in older adults with more fulminate disease as observed with acute hepatitis A and a more rapid progression to cirrhosis with hepatitis C. • Outbreaks of viral gastroenteritis are common in long-term care facilities, and infection may lead to death due to dehydration and oliguria. • The incidence of herpes zoster increases with advancing age and carries with it a significant risk of post herpetic neuralgia. The use of antiviral medications and corticosteroids may reduce the incidence and severity of chronic pain. Respiratory VirusesAcute respiratory tract infections (ARI) occur commonly throughout life, accounting for substantial morbidity and mortality in older adults (1) . Due to influenza's epidemic nature and its ready growth in cell culture, it was commonly the only viral pathogen identified in many early etiologic studies of ARI in adults. Recent studies employing reverse transcription polymerase chain reaction (RT-PCR) and sensitive serology indicate that a wide variety of viruses including respiratory syncytial virus (RSV),

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Clinical and laboratory evaluation of elderly patients with heterophil-antibody positive infectious mononucleosis

Cited by 53 publications

References 27 publications

Accuracy of Signs, Symptoms, and Hematologic Parameters for the Diagnosis of Infectious Mononucleosis: A Systematic Review and Meta-Analysis

Accuracy of Signs, Symptoms, and Hematologic Parameters for the Diagnosis of Infectious Mononucleosis: A Systematic Review and Meta-Analysis

Fever of Unknown Origin in Elderly Patients

Viral Infections

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