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Mononukleose

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
Systemisk blodinfeksjon med halsinfeksjon og lymfeknutesvulst. Forårsaket av Epstein-Barr-virus
Forekomst:
Høyest i aldersgruppen 10-19 år hvor insidens er 6-8 tilfeller per 1000 personer per år
Symptomer:
Ofte asymptomatisk. Typiske symptomer er halsbetennelse, cervikal lymfadenitt og generell lymfeknutesvulst, ofte forstørret lever og milt.
Funn:
Halsinfeksjon, ofte medtatt allmenntilstand. Uttalt cervikal lymfadenitt og generell lymfeknutesvulst.
Diagnostikk:
Antistoffer påvises i hurtigtest etter 1-2 uker. Lymfocytose i blodutstryk i akuttfase. Diagnosen bekreftes ev. ved ordinær antistofftest.
Behandling:
Symptomlindrende behandling med avlastning og væsketilførsel. Innleggelse for intravenøs væskebehandling aktuelt i unntakstifeller.
  1. Womack J, Jimenez M. Common questions about infectious mononucleosis. Am Fam Physician 2015 Mar 15;91(6):372-376. www.aafp.org  
  2. Hurt C, Tammaro D. Diagnostic evaluation of mononucleosis-like illnesses. Am J Med 2007; 120: 911e1-8.
  3. Ebell MH, Call M, Shinholser J, et al. Does This Patient Have Infectious Mononucleosis?: The Rational Clinical Examination Systematic Review. JAMA 2016. pmid:27115266 PubMed  
  4. Balfour HH Jr, Holman CJ, Hokanson KM, et al. A prospective clinical study of Epstein-Barr virus and host interactions during acute infectious mononucleosis. J Infect Dis 2005; 192: 1503. PubMed  
  5. Aronson MD, Auwaerter PG. Infectious mononucleosis. UpToDate, last updated Mar 19, 2021. www.uptodate.com  
  6. Ng S-B, Khoury JD. Epstein-Barr virus in lymphoproliferative processes. Adv Anat Pathol 2009; 16: 40-55. PubMed  
  7. Sullivan JL. Virology of Epstein-Barr virus. UpToDate. Last updated Mar 05, 2021. UpToDate  
  8. Fafi-Kremer, S, Morand, P, Brion, JP, et al. Long-term shedding of infectious epstein-barr virus after infectious mononucleosis. J Infect Dis 2005; 191: 985. PubMed  
  9. Hurt C, Tammaro D. Diagnostic evaluation of mononucleosis-like illnesses. Am J Med. 2007;120(10):911.e1.–8.
  10. Rezk E, Nofal YH, Hamzeh A, Aboujaib MF, AlKheder MA, Al Hammad MF. Steroids for symptom control in infectious mononucleosis. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD004402. DOI: 10.1002/14651858.CD004402.pub3. DOI  
  11. Pagano JS, Whitehurst CB, Andrei G. Antiviral Drugs for EBV. Cancers (Basel). 2018 Jun 13;10(6):197. PMID: 29899236. PubMed  
  12. Becker JA, Smith JA. Return to play after infectious mononucleosis. Sports Health. 2014;6(3):232-238. PubMed  
  13. Putukian M, O'Connor FG, Stricker P, et al. Mononucleosis and athletic participation: an evidence-based subject review. Clin J Sport Med. 2008;18(4):309–315.
  14. Doja A, Bitnun A, Ford Jones EL, et al. Pediatric Epstein-Barr virus-associated encephalitis: 10-year review. J Child Neurol. 2006;21:384-391. PubMed  
  15. Smittervernveilederen. Mononukleose - veileder for helsepersonell. Folkehelseinstituttet. Sist oppdatert 18.04.2019. fhi.no  
  16. Pedersen M, Asprusten TT, Godang K, et al. Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: A prospective cohort study. Brain Behav Immun. 2019;75:94-100. PubMed  
  17. Katz BZ, Reuter C, Lupovitch Y, et al. A Validated Scale for Assessing the Severity of Acute Infectious Mononucleosis. J Pediatr 2019; 209:130. PubMed  
  18. Aster JC, Pozdnyakova O, Armbinder RF. Pathogenesis of Hodgkin lymphoma. UpToDate, last updated Feb 15, 2021. UpToDate  
  19. Hjalgrim H, Askling J, Rostgaard K, et al. Characteristics of Hodkin's lymphoma after infectious mononucleosis. N Engl J Med 2003; 349: 1324-32. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Morten Lindbæk, førsteamanuensis, spesialist i allmennmedisin, Institutt for allmennmedisin og samfunnsmedisinske fag, Universitetet i Oslo
  • Per Hjortdahl, professor i allmennmedisin, Institutt for samfunnsmedisinske fag, Universitetet i Oslo
  • Kurt Østhuus Krogh, spesialist i barnesykdommer, Barne- og ungdomsklinikken, St. Olavs Hospital, Trondheim