ICD-10: B27.0

Gammaherpesviral mononucleosis

Clinical Information

Inclusion Terms

  • Mononucleosis due to Epstein-Barr virus

Additional Information

Description

Gammaherpesviral mononucleosis, classified under ICD-10 code B27.0, is a viral infection primarily associated with the Epstein-Barr virus (EBV), which is a member of the gammaherpesvirus family. This condition is characterized by a range of clinical symptoms and laboratory findings that can help in its diagnosis and management.

Clinical Description

Etiology

Gammaherpesviral mononucleosis is most commonly caused by the Epstein-Barr virus, which is known for its role in infectious mononucleosis. The virus is typically transmitted through saliva, which is why it is often referred to as the "kissing disease." Other members of the gammaherpesvirus family, such as cytomegalovirus (CMV), can also cause similar symptoms but are less frequently associated with this specific diagnosis.

Symptoms

The clinical presentation of gammaherpesviral mononucleosis can vary but generally includes:

  • Fever: Often one of the first symptoms, it can be high and persistent.
  • Sore Throat: Severe pharyngitis is common, often accompanied by swollen tonsils.
  • Lymphadenopathy: Swelling of lymph nodes, particularly in the neck and armpits, is a hallmark of the condition.
  • Fatigue: Patients frequently report significant tiredness that can last for weeks.
  • Rash: Some individuals may develop a rash, although this is less common.
  • Splenomegaly: Enlargement of the spleen can occur, leading to abdominal discomfort.

Diagnosis

Diagnosis of gammaherpesviral mononucleosis typically involves:

  • Clinical Evaluation: A thorough history and physical examination to assess symptoms and signs.
  • Laboratory Tests: Blood tests may reveal atypical lymphocytes, elevated liver enzymes, and positive heterophile antibodies (Monospot test). Specific serological tests for EBV, such as VCA-IgM and VCA-IgG, can confirm the diagnosis.

Complications

While most cases resolve without significant issues, complications can arise, including:

  • Splenic Rupture: Due to splenomegaly, there is a risk of splenic rupture, which is a medical emergency.
  • Hepatitis: Liver involvement can lead to hepatitis, indicated by elevated liver enzymes.
  • Neurological Complications: Rarely, EBV can lead to neurological issues such as meningitis or encephalitis.

Management

Management of gammaherpesviral mononucleosis is primarily supportive, focusing on symptom relief:

  • Hydration: Ensuring adequate fluid intake is crucial.
  • Pain Relief: Over-the-counter analgesics, such as acetaminophen or ibuprofen, can help alleviate fever and throat pain.
  • Rest: Patients are advised to rest to aid recovery.

In severe cases, particularly with complications, hospitalization may be required for more intensive management.

Conclusion

Gammaherpesviral mononucleosis, represented by ICD-10 code B27.0, is a viral infection primarily caused by the Epstein-Barr virus, characterized by symptoms such as fever, sore throat, and lymphadenopathy. Diagnosis is confirmed through clinical evaluation and laboratory tests, while management focuses on supportive care. Awareness of potential complications is essential for effective treatment and patient safety.

Clinical Information

Gammaherpesviral mononucleosis, classified under ICD-10 code B27.0, is primarily associated with infections caused by the Epstein-Barr virus (EBV) and, less commonly, by other gammaherpesviruses. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for accurate diagnosis and management.

Clinical Presentation

Signs and Symptoms

The clinical presentation of gammaherpesviral mononucleosis can vary significantly among patients, but common signs and symptoms include:

  • Fever: A high fever is often one of the first symptoms, typically ranging from mild to severe.
  • Sore Throat: Patients frequently report a severe sore throat, which may resemble streptococcal pharyngitis.
  • Lymphadenopathy: Swelling of lymph nodes, particularly in the neck and armpits, is a hallmark of the condition.
  • Fatigue: Profound fatigue and malaise are common, often lasting for weeks.
  • Rash: Some patients may develop a rash, which can vary in appearance.
  • Splenomegaly: Enlargement of the spleen is often noted during physical examination.
  • Hepatomegaly: Liver enlargement may also occur, although it is less common than splenomegaly.

Additional Symptoms

Other symptoms that may be present include:

  • Headache: Patients often experience headaches, which can be persistent.
  • Muscle Aches: Myalgia is frequently reported, contributing to overall discomfort.
  • Nausea: Some individuals may experience gastrointestinal symptoms, including nausea and loss of appetite.

Patient Characteristics

Demographics

Gammaherpesviral mononucleosis can affect individuals of all ages, but certain demographic trends are observed:

  • Age: It is most commonly diagnosed in adolescents and young adults, particularly those between the ages of 15 and 24.
  • Sex: There is no significant gender predisposition, although some studies suggest a slightly higher incidence in females.

Risk Factors

Several risk factors may increase the likelihood of developing gammaherpesviral mononucleosis:

  • Close Contact: The virus is often transmitted through saliva, making close contact (e.g., kissing, sharing drinks) a significant risk factor.
  • Immunocompromised Status: Individuals with weakened immune systems, such as those with HIV/AIDS or undergoing immunosuppressive therapy, are at higher risk for severe manifestations of the disease.
  • Environmental Factors: Crowded living conditions, such as dormitories or military barracks, can facilitate the spread of the virus.

Conclusion

Gammaherpesviral mononucleosis, represented by ICD-10 code B27.0, presents with a range of symptoms primarily affecting the lymphatic system and causing systemic illness. Recognizing the clinical signs, such as fever, sore throat, and lymphadenopathy, along with understanding patient demographics and risk factors, is essential for healthcare providers in diagnosing and managing this viral infection effectively. Early identification and supportive care can help mitigate complications and improve patient outcomes.

Approximate Synonyms

Gammaherpesviral mononucleosis, classified under ICD-10 code B27.0, is primarily associated with infections caused by the Epstein-Barr virus (EBV), which is a member of the gammaherpesvirus family. Understanding the alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some of the key alternative names and related terms associated with B27.0.

Alternative Names

  1. Infectious Mononucleosis: This is the most common term used to describe the clinical syndrome associated with EBV infection, characterized by fever, sore throat, and lymphadenopathy.

  2. Glandular Fever: This term is often used interchangeably with infectious mononucleosis, particularly in some regions, such as the UK.

  3. EBV Mononucleosis: This term specifies that the mononucleosis is caused by the Epstein-Barr virus, providing clarity on the viral etiology.

  4. Viral Mononucleosis: A broader term that can refer to mononucleosis caused by various viral infections, but often used in the context of EBV.

  5. Kissing Disease: A colloquial term that refers to the transmission of EBV through saliva, commonly associated with the behavior of kissing.

  1. Epstein-Barr Virus (EBV): The virus responsible for gammaherpesviral mononucleosis, which is a member of the herpesvirus family.

  2. Herpesvirus: A broader category of viruses that includes EBV and is relevant in the context of gammaherpesviral infections.

  3. Lymphoproliferative Disorders: Conditions that may arise from EBV infection, particularly in immunocompromised individuals.

  4. Cytomegalovirus (CMV) Mononucleosis: While distinct, CMV can cause a similar clinical picture, and the terms may sometimes be confused in clinical settings.

  5. Acute Viral Pharyngitis: A term that may describe the throat symptoms associated with mononucleosis, although it is not specific to EBV.

  6. Viral Lymphadenopathy: Refers to the swollen lymph nodes that are a common symptom of gammaherpesviral mononucleosis.

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing, documenting, and discussing cases of gammaherpesviral mononucleosis. This knowledge also aids in patient education and communication regarding the condition.

Diagnostic Criteria

Gammaherpesviral mononucleosis, classified under ICD-10 code B27.0, is primarily associated with infections caused by the Epstein-Barr virus (EBV) and, in some cases, other gammaherpesviruses. The diagnosis of this condition involves a combination of clinical evaluation, laboratory testing, and consideration of epidemiological factors. Below are the key criteria used for diagnosis:

Clinical Criteria

  1. Symptoms: Patients typically present with a constellation of symptoms that may include:
    - Severe fatigue
    - Fever
    - Sore throat
    - Swollen lymph nodes (lymphadenopathy)
    - Hepatosplenomegaly (enlarged liver and spleen)
    - Rash (in some cases)

  2. Physical Examination: A thorough physical examination may reveal:
    - Enlarged lymph nodes, particularly in the neck
    - Signs of liver dysfunction (e.g., tenderness in the upper right quadrant)
    - Splenomegaly

Laboratory Criteria

  1. Serological Tests: The diagnosis is often supported by serological tests that detect antibodies against EBV, including:
    - Viral Capsid Antigen (VCA): Presence of IgM and IgG antibodies can indicate recent or past infection.
    - Early Antigen (EA): The presence of IgG antibodies to EA suggests active infection.
    - Nuclear Antigen (EBNA): The presence of IgG antibodies to EBNA typically indicates past infection.

  2. Complete Blood Count (CBC): A CBC may show:
    - Lymphocytosis (increased lymphocyte count)
    - Atypical lymphocytes (abnormal lymphocytes that are larger than normal)

  3. Liver Function Tests: Elevated liver enzymes (ALT, AST) may indicate liver involvement.

  4. Polymerase Chain Reaction (PCR): In some cases, PCR testing may be used to detect EBV DNA in blood or other tissues, particularly in severe or atypical cases.

Epidemiological Factors

  1. Age and Exposure: Gammaherpesviral mononucleosis is more common in adolescents and young adults, often following exposure to the virus through saliva (e.g., kissing or sharing drinks).

  2. History of Previous Infections: A history of previous EBV infections or related illnesses may provide context for the diagnosis.

Differential Diagnosis

It is essential to differentiate gammaherpesviral mononucleosis from other conditions that can present similarly, such as:
- Cytomegalovirus (CMV) infection
- Other viral infections (e.g., HIV, hepatitis)
- Bacterial infections (e.g., streptococcal pharyngitis)

Conclusion

The diagnosis of gammaherpesviral mononucleosis (ICD-10 code B27.0) relies on a combination of clinical symptoms, laboratory findings, and epidemiological context. Accurate diagnosis is crucial for appropriate management and to rule out other potential causes of the symptoms. If you suspect gammaherpesviral mononucleosis, it is advisable to consult a healthcare professional for a comprehensive evaluation and testing.

Treatment Guidelines

Gammaherpesviral mononucleosis, classified under ICD-10 code B27.0, is primarily associated with infections caused by the Epstein-Barr virus (EBV) and, less commonly, by other gammaherpesviruses. This condition is characterized by symptoms similar to those of infectious mononucleosis, including fever, sore throat, lymphadenopathy, and fatigue. Understanding the standard treatment approaches for this condition is essential for effective management.

Overview of Gammaherpesviral Mononucleosis

Gammaherpesviral mononucleosis typically arises from EBV, which is a member of the herpesvirus family. It is most commonly transmitted through saliva, leading to its colloquial name, "kissing disease." The infection can result in a range of symptoms, from mild to severe, and may lead to complications such as splenic rupture or secondary infections.

Standard Treatment Approaches

1. Symptomatic Management

The primary approach to treating gammaherpesviral mononucleosis is symptomatic management, as there is no specific antiviral treatment for EBV. Key components include:

  • Rest: Patients are advised to get plenty of rest to help the immune system fight the virus.
  • Hydration: Maintaining adequate fluid intake is crucial to prevent dehydration, especially if fever is present.
  • Pain Relief: Over-the-counter analgesics such as acetaminophen or ibuprofen can help alleviate fever and throat pain.
  • Throat Care: Gargling with salt water or using throat lozenges can provide relief for sore throats.

2. Corticosteroids

In cases where patients experience severe symptoms, such as significant airway obstruction due to lymphadenopathy or severe thrombocytopenia, corticosteroids may be prescribed. These can help reduce inflammation and swelling, providing symptomatic relief. However, their use is generally reserved for more severe cases due to potential side effects.

3. Monitoring and Follow-Up

Regular monitoring of the patient's condition is essential, especially in cases with complications. Healthcare providers may conduct follow-up visits to assess recovery and manage any arising issues, such as splenic enlargement or secondary infections.

4. Avoiding Contact Sports

Patients are often advised to avoid contact sports and heavy physical activity for several weeks to prevent the risk of splenic rupture, which can occur due to splenomegaly associated with the infection.

Conclusion

In summary, the treatment of gammaherpesviral mononucleosis primarily focuses on symptomatic relief and supportive care, as there is no specific antiviral therapy available for EBV. Corticosteroids may be utilized in severe cases, and careful monitoring is essential to manage potential complications. Patients are encouraged to rest, stay hydrated, and follow up with healthcare providers to ensure a safe recovery. If symptoms persist or worsen, further evaluation may be necessary to rule out other underlying conditions.

Related Information

Description

  • Viral infection caused by Epstein-Barr virus
  • Primarily transmitted through saliva
  • Fever often one of the first symptoms
  • Sore throat with severe pharyngitis common
  • Lymphadenopathy with swelling in neck and armpits
  • Fatigue that can last for weeks
  • Rash less common but may occur
  • Splenomegaly leading to abdominal discomfort
  • Diagnosis involves clinical evaluation and lab tests
  • Blood tests reveal atypical lymphocytes and elevated liver enzymes

Clinical Information

  • Fever often one of the first symptoms
  • Severe sore throat common symptom
  • Lymphadenopathy swelling of lymph nodes
  • Fatigue and malaise last for weeks
  • Rash can occur in some patients
  • Splenomegaly enlargement of spleen noted
  • Hepatomegaly liver enlargement less common
  • Headache is a frequent symptom
  • Muscle aches contribute to discomfort
  • Nausea and loss of appetite reported

Approximate Synonyms

  • Infectious Mononucleosis
  • Glandular Fever
  • EBV Mononucleosis
  • Viral Mononucleosis
  • Kissing Disease

Diagnostic Criteria

  • Severe fatigue
  • Fever
  • Sore throat
  • Lymphadenopathy
  • Hepatosplenomegaly
  • Rash
  • Enlarged lymph nodes
  • Liver dysfunction
  • Splendomegaly
  • VCA IgM and IgG antibodies
  • EA IgG antibodies
  • EBNA IgG antibodies
  • Lymphocytosis
  • Atypical lymphocytes
  • Elevated liver enzymes

Treatment Guidelines

  • Rest and adequate hydration
  • Pain relief with acetaminophen or ibuprofen
  • Throat care with salt water gargling
  • Corticosteroids for severe symptoms only
  • Monitoring and follow-up appointments
  • Avoiding contact sports and heavy physical activity

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