Coinfection of Influenza Virus and Group A Streptococcus in an Adult Suspected with Infectious Mononucleosis by Epstein-Barr Virus Infection

Background The risk of infectious mononucleosis (IM) is affected both by crowding and by sibship structure, i.e., number and signed age differential between an index child and a sibling. Siblings provide protection against IM by pre-empting delayed primary Epstein-Barr virus infection with its associated high risk of IM. The association between childcare attendance and risk of IM, on the other hand, has never been studied in a large, well-characterized cohort. Methods Danish children born in July 1992 through 2016 with a completely known simple childcare attendance history before age 1.5 years (n = 908,866) were followed up for a hospital contact with an IM diagnosis at ages 1.5–26 years. Hazard ratios (HRs) of IM for an additional year of exposure were obtained from stratified Cox regression analyses, stratified by sex and year of birth, with age as the underlying time scale, adjusted for sibship structure, and sociodemographic variables including parental ethnicity and maternal age. Results An additional year of exclusively attending a daycare home (max 5 children) yielded HR = 0.90 (95% confidence interval 0.81–1.00), and similarly, each year of exclusively attending a childcare institution (e.g., crèche) yielded HR = 0.94 (0.84–1.06). Conclusions Forwarding enrollment in childcare by a year lowers the risk of IM later in life much less than having an additional sibling of comparable age and has no practical public health implications. We find our results suggestive of a random threshold for successful Epstein-Barr virus infection that is more easily reached by a sibling than the collective of playmates in daycare homes or childcare institutions.

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MR Findings in Isolated Oculomotor Nerve Palsy Associated with Infectious Mononucleosis Caused by Epstein-Barr Virus Infection

Journal of Computer Assisted Tomography ◽

10.1097/00004728-199811000-00029 ◽

1998 ◽

Vol 22 (6) ◽

pp. 995-997 ◽

Cited By ~ 5

Author(s):

Akira Ishibashi ◽

Keiko Sueyoshi ◽

Masayoshi You ◽

Yoshitake Yokokura

Keyword(s):

Virus Infection ◽

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Nerve Palsy ◽

Oculomotor Nerve ◽

Oculomotor Nerve Palsy ◽

Epstein Barr Virus Infection ◽

Barr Virus ◽

Epstein Barr ◽

Barr Virus Infection

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Epstein-Barr Virus Infection and Infectious Mononucleosis

Family Medicine ◽

10.1007/978-1-4757-2947-4_38 ◽

1998 ◽

pp. 325-327

Author(s):

James McSherry

Keyword(s):

Virus Infection ◽

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Epstein Barr Virus Infection ◽

Barr Virus ◽

Epstein Barr ◽

Barr Virus Infection

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Lemierre's and Lemierre's-like syndromes in association with infectious mononucleosis

The Journal of Laryngology & Otology ◽

10.1017/s0022215110001568 ◽

2010 ◽

Vol 124 (12) ◽

pp. 1257-1262 ◽

Cited By ~ 13

Author(s):

E M Chacko ◽

L R Krilov ◽

W Patten ◽

P J Lee

Keyword(s):

Virus Infection ◽

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Epstein Barr Virus Infection ◽

Lemierre’S Syndrome ◽

Heterophile Antibody ◽

Barr Virus ◽

Epstein Barr ◽

Barr Virus Infection ◽

Lemierre's Syndrome

AbstractObjective:This study aimed to review cases of Lemierre's and Lemierre's-like syndromes in paediatric patients, to examine a possible association with Epstein–Barr virus as a predisposing factor, and to assess the impact of this virus on the severity of illness.Methods:We performed a retrospective analysis of data from the in-patient database at Winthrop University Hospital, from January 2001 to October 2007. We reviewed clinical and laboratory findings as well as the outcome of infection in patients aged 21 years or less with a diagnosis of Lemierre's syndrome. An additional case of Lemierre's-like syndrome was also included. The illness severity and duration of in-patient management of those testing positive for heterophile antibody were then compared with the same parameters in patients who tested negative.Results:Of the five patients diagnosed with Lemierre's syndrome, two had concomitant acute infection with Epstein–Barr virus. Additionally, a 19-year-old adolescent was admitted during this period with acute infectious mononucleosis, Fusobacterium necrophorum sepsis, sinusitis, frontal lobe abscess and ophthalmic vein thrombosis. The clinical presentation of all patients included fever, sore throat, and ear or neck pain. The duration of symptoms ranged from two days to three weeks prior to admission. The patients with acute Epstein–Barr virus infection had been diagnosed with infectious mononucleosis prior to admission, and tested positive for heterophile antibody. These patients subsequently underwent more extensive in-patient treatment, including intensive care management and ventilator support. The patients who tested negative for heterophile antibody experienced a milder course of illness, with a shorter duration of in-patient management.Conclusion:Two patients diagnosed with Lemierre's syndrome, and a third with Fusobacterium necrophorum sepsis, had coexisting acute Epstein–Barr virus infection. Patients who tested positive for heterophile antibody experienced a more severe course of illness. These observations suggest a possible association between Epstein–Barr virus infection and the severity of concomitant Lemierre's syndrome.

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