Epstein-Barr Virus

One-Sentence Definition

Epstein-Barr virus (EBV) is a gamma-herpesvirus that infects B cells, causes infectious mononucleosis, and is linked to several malignancies and post-transplant lymphoproliferative disease.

Taxonomy & Morphology

• Human herpesvirus 4; dsDNA; envelope
• Latency programs in B cells (and epithelial cells)

Virulence Highlights

• Infects B cells via CD21; drives proliferation (IM)
• Latency-associated malignancy risk (Burkitt, Hodgkin, NPC, PTLD)
• Oral shedding — transmission via saliva (“kissing disease”)

Clinical Syndromes

• Infectious mononucleosis — fever, pharyngitis, lymphadenopathy, atypical lymphocytes
• Complications: splenic rupture, airway obstruction, hepatitis
• Immunosuppression: PTLD
• Chronic active EBV (rare)

Diagnosis

• Serology: VCA IgM/IgG, EBNA patterns
• Heterophile (Monospot) — rapid screen (false negatives early/in kids)
• PCR for high-risk/immunocompromised contexts
• Avoid ampicillin/amoxicillin rash trap in IM

Treatment / Prevention

• Supportive for typical IM
• Antivirals limited efficacy in IM; rituximab/ chemo in malignancy/PTLD contexts
• No licensed vaccine broadly available

Related Notes

• Adaptive Immunity · HEENT Infections · MOC - Virology
• Serology in Clinical Microbiology

Active Recall

1. Monospot tests what indirectly?
2. Why avoid amoxicillin in EBV IM?
3. Latency cell type?