Mononucleosis

Descripción General

Definición

La mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis infecciosa es una enfermedad infecciosa viral más frecuentemente causada por el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de Epstein-Barr ( EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) y se caracteriza por una tríada de fiebre, faringoamigdalitis y linfadenopatía.

Sinónimos

• Síndrome de mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis
• Enfermedad de Pfeiffer o fiebre glandular de Pfeiffer
• “Mono” o “enfermedad del beso”

Epidemiología

• Aproximadamente el 90% de los LOS Neisseria adultos a nivel mundial son seropositivos para el VEB; las tasas de seroprevalencia entre niños y adolescentes han ido disminuyendo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum algunas poblaciones.
• Ocurre con más frecuencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum primavera y otoño
• Los LOS Neisseria niños y adolescentes de 15–19 años son los LOS Neisseria más afectados
• Una causa común de faringitis viral, especialmente entre los LOS Neisseria adultos jóvenes de Estados Unidos
• Datos recientes de EE. UU. (NHANES) muestran que la seroprevalencia es en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum realidad mayor entre los LOS Neisseria niños y adolescentes no blancos, aunque la MI MI MI is ischemia and death of an area of myocardial tissue due to insufficient blood flow and oxygenation, usually from thrombus formation on a ruptured atherosclerotic plaque in the epicardial arteries. Clinical presentation is most commonly with chest pain, but women and patients with diabetes may have atypical symptoms. Myocardial Infarction sintomática se reporta con mayor frecuencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum poblaciones blancas.

Etiología

El EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus pertenece al AL Amyloidosis grupo de los LOS Neisseria herpesvirus humanos (HHV-4, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés).

Fisiopatología

Patogenicidad

El EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus tiene una especificidad de especie excepcionalmente alta:

• Se replica casi exclusivamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células epiteliales humanas de la orofaringe y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria linfocitos B
• No se han obtenido muestras en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el medio ambiente, lo que sugiere que su principal reservorio es el ser humano

Transmisión

La enfermedad se transmite principalmente por contacto con secreciones corporales, sobre todo orofaríngeas.

• Infección por contacto directo: especialmente frecuente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños a través de los LOS Neisseria padres, compañeros de juego, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC).
• Infección indirecta: al AL Amyloidosis tocar objetos contaminados (por ejemplo, un vaso).
• Infección por contacto:
  • Especialmente frecuente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adolescentes, por saliva Saliva The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptyalin. Salivary Glands: Anatomy infectada al AL Amyloidosis besarse y compartir bebidas.
  • Los LOS Neisseria besos parecen ser una vía más importante que el coito.
• La transmisión a través de transfusiones de sangre y trasplantes de órganos es poco común porque la mayoría de los LOS Neisseria receptores ya son seropositivos al AL Amyloidosis VEB y gracias a las prácticas de leucorreducción.
• La transmisión vertical del VEB parece ser la excepción más que la regla.

Enfermedad

• Desde la orofaringe, el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology se propaga por todo el cuerpo:
  • Infecta:
    • Epitelios CD21 CD21 Molecular sites on or in B-lymphocytes, follicular dendritic cells, lymphoid cells, and epithelial cells that recognize and combine with complement C3D. Human complement receptor 2 (CR2) serves as a receptor for both C3dg and the gp350/220 glycoprotein of Human Herpesvirus 4 and binds the monoclonal antibody OKB7, which blocks binding of both ligands to the receptor. Epstein-Barr Virus positivos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orofaringe y las glándulas salivales
    • Linfocitos B
  • A continuación, los LOS Neisseria linfocitos infectados se infiltran en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum otros tejidos linfoides de todo el sistema linforreticular.
• Se desencadena una respuesta de células T citotóxicas → hiperplasia linfoide que se manifiesta como:
  • Amigdalitis
  • Linfadenopatía
  • Hepatoesplenomegalia
• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la infección primaria por VEB, hay una producción masiva de:
  • Anticuerpos contra el VEB
  • Anticuerpos contra antígenos no relacionados (anticuerpos heterófilos)
  • Otros anticuerpos (e.g., contra plaquetas → trombocitopenia)
• Tras la respuesta inmunitaria inicial, el VEB permanece en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una serie de linfocitos infectados (latencia):
  • La excreción oral suele persistir durante 6 meses después de la enfermedad y puede continuar de forma intermitente durante décadas.
  • Reactivación:
    • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria individuos inmunocompetentes, los LOS Neisseria síntomas serían mínimos o inexistentes.
    • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum individuos inmunocomprometidos, se produce una infección sintomática por VEB y/o se desarrolla una neoplasia maligna relacionada con el VEB.

Presentación Clínica

• Periodo de incubación: 4–8 semanas
• Estadio prodrómico: suele ser asintomático (especialmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños < 10 años, de los LOS Neisseria cuales solo el 10% son sintomáticos) pero puede incluir malestar, cefalea y fiebre baja
• Los LOS Neisseria síntomas se presentan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adolescentes y adultos, y duran entre 2–4 semanas.

Tríada clásica de síntomas

1. Fiebre
2. Amigdalitis (amígdalas agrandadas y eritematosas que pueden estar cubiertas de exudado)/ faringitis
3. Linfadenopatía cervical
   • Más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las cadenas cervicales posteriores y auriculares posteriores
   • Usualmente simétrica

Síntomas adicionales

• Cefalea
• Malestar general que puede progresar a fatiga persistente y severa
• Petequias presentes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la unión entre el paladar duro y el blando
• Halitosis Halitosis An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. Oral Cancer: aliento fétido
• Hepato-, espleno-, o hepatoesplenomegalia
  • Puede presentarse con dolor Dolor Inflammation abdominal y/o ictericia
• Aumento de volumen generalizado de los LOS Neisseria ganglios linfáticos (ganglios sensibles, firmes y móviles)
• Erupción maculopapular Maculopapular Dermatologic Examination (similar al AL Amyloidosis sarampión, presente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum aproximadamente el 5% de los LOS Neisseria casos)

Síndrome de Hoagland:

• Párpados superiores hinchados o edematosos: una manifestación única de la MI MI MI is ischemia and death of an area of myocardial tissue due to insufficient blood flow and oxygenation, usually from thrombus formation on a ruptured atherosclerotic plaque in the epicardial arteries. Clinical presentation is most commonly with chest pain, but women and patients with diabetes may have atypical symptoms. Myocardial Infarction aguda
• Se desconoce la fisiopatología del signo de Hoagland, pero se cree que es el resultado de una infiltración linfocítica.

Síndromes neurológicos:

• Peden aparecer 2–4 semanas después de la aparición de los LOS Neisseria síntomas iniciales
• Puede incluir:
  • Síndrome de Guillain-Barré
  • Parálisis facial y de otros nervios craneales
  • Inflamación aséptica del cerebro, las meninges Meninges The brain and the spinal cord are enveloped by 3 overlapping layers of connective tissue called the meninges. The layers are, from the most external layer to the most internal layer, the dura mater, arachnoid mater, and pia mater. Between these layers are 3 potential spaces called the epidural, subdural, and subarachnoid spaces. Meninges: Anatomy y/o los LOS Neisseria nervios centrales y periféricos

Mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis crónica:

• Rara, se debe a la replicación viral persistente (infección crónica, activa por EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus)
• Presentación:
  • Fiebre crónica o recurrente
  • Fatiga
  • Pérdida de peso
  • Linfadenopatía
  • Citopenia
  • Neumonía intersticial
  • Hepatitis

Diagnóstico

El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria síntomas clínicos señalados anteriormente junto a las pruebas de confirmación.

• Laboratorio:
  • Leucocitosis linfocítica con > 50% de linfocitos y > 10% de linfocitos atípicos (linfocitos T CD8+ activados) es altamente sugestiva de MI MI MI is ischemia and death of an area of myocardial tissue due to insufficient blood flow and oxygenation, usually from thrombus formation on a ruptured atherosclerotic plaque in the epicardial arteries. Clinical presentation is most commonly with chest pain, but women and patients with diabetes may have atypical symptoms. Myocardial Infarction.
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types leve, neutropenia Neutropenia Neutrophils are an important component of the immune system and play a significant role in the eradication of infections. Low numbers of circulating neutrophils, referred to as neutropenia, predispose the body to recurrent infections or sepsis, though patients can also be asymptomatic. Neutropenia y trombocitopenia
  • ↑ Velocidad de eritrosedimentación
  • ↑ Proteína C reactiva
  • Leve ↑ transaminasas, fosfatasa alcalina y bilirrubina total
• Prueba rápida para la mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis, prueba monospot o prueba de anticuerpos heterófilos:
  • Detecta los LOS Neisseria anticuerpos heterófilos producidos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum respuesta a la infección por EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus
  • Tiene una sensibilidad de aproximadamente el 87 % y una especificidad de aproximadamente el 91 %, con altas tasas de falsos negativos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las primeras 1-2 semanas de la enfermedad y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños menores de 4 años.
  • Si hay reactividad, no es necesario realizar más pruebas
• Serología:
  • Detecta anticuerpos contra el EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus
  • La IgM IgM A class of immunoglobulin bearing mu chains (immunoglobulin mu-chains). Igm can fix complement. The name comes from its high molecular weight and originally being called a macroglobulin. Immunoglobulins: Types and Functions positiva contra el antígeno de la cápside viral (VCA) junto con IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis anti-VCA positiva e IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis negativa contra el antígeno nuclear del VEB (EBNA) indican infección aguda/reciente.
  • La IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis anti-VCA positiva con IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis anti-EBNA positiva indica infección pasada.
• Histopatología de los LOS Neisseria ganglios linfáticos:
  • No es necesario para el diagnóstico
  • El cuadro de hiperplasia polimórfica de la pulpa es típico.
  • La propagación en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria ganglios linfáticos y el rápido crecimiento de las células blásticas/ necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage están presentes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la muestra histológica.

Resumen

Si se sospecha de mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis infecciosa por los LOS Neisseria antecedentes y el examen físico, pedir un recuento de leucocitos con diferencial y una prueba de anticuerpos heterófilos.

• Heterófilo +: no se necesitan más pruebas, se confirma el diagnóstico de mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis infecciosa
• Heterófilo –:
  • No descarta la mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis infecciosa.
  • Si la sospecha clínica persiste, realice serología específica para VEB ( IgM IgM A class of immunoglobulin bearing mu chains (immunoglobulin mu-chains). Igm can fix complement. The name comes from its high molecular weight and originally being called a macroglobulin. Immunoglobulins: Types and Functions/ IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis anti-VCA e IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis anti-EBNA).
  • Considere causas alternativas como citomegalovirus (CMV), VIH, toxoplasmosis Toxoplasmosis Toxoplasmosis is an infectious disease caused by Toxoplasma gondii, an obligate intracellular protozoan parasite. Felines are the definitive host, but transmission to humans can occur through contact with cat feces or the consumption of contaminated foods. The clinical presentation and complications depend on the host’s immune status. Toxoplasma/Toxoplasmosis o HHV-6 HHV-6 Human herpesvirus (HHV)-6 and HHV-7 are similar double-stranded DNA viruses belonging to the Herpesviridae family. Human herpesviruses are ubiquitous and infections are commonly contracted during childhood. Human Herpesvirus 6 and 7 si la serología para VEB es negativa.

Tratamiento y Pronóstico

Actualmente no existe una terapia antiviral Antiviral Antivirals for Hepatitis B específica, por lo que el tratamiento es de soporte.

• El tratamiento sintomático incluye:
  • Restricción de toda actividad atlética durante al AL Amyloidosis menos 3 semanas después del inicio de los LOS Neisseria síntomas, y de deportes de contacto/extenuantes durante al AL Amyloidosis menos 4 semanas, para reducir el riesgo de rotura esplénica.
  • Antipiréticos y analgésicos (e.g., paracetamol paracetamol Acetaminophen is an over-the-counter nonopioid analgesic and antipyretic medication and the most commonly used analgesic worldwide. Despite the widespread use of acetaminophen, its mechanism of action is not entirely understood. Acetaminophen, antiinflamatorios no esteroideos)
  • Adecuada ingesta de líquidos y nutrientes
• La administración de penicilina y aminopenicilinas puede desencadenar la formación de erupciones.
• Los LOS Neisseria corticosteroides no se recomiendan para el alivio sintomático rutinario, pero están indicados en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum complicaciones graves como obstrucción inminente de la vía aérea, anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica autoinmune o trombocitopenia grave.

Pronóstico

• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum general, es frecuente una resolución favorable y se desarrolla una inmunidad duradera.
• La evolución de la enfermedad es más grave en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las personas con inmunodeficiencias (incluidos los LOS Neisseria receptores de trasplantes).
• Las infecciones crónicas son extremadamente raras.
• Latencia del virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células B → mayor riesgo de trastornos linfoproliferativos asociados al AL Amyloidosis VEB y linfoma de células B en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes inmunocomprometidos (e.g., postrasplante, personas con VIH/SIDA).

Complicaciones

Sobreinfección bacteriana
La faringitis estreptocócica secundaria puede ocurrir, pero es poco común; las tasas reportadas varían ampliamente.

Cardíacas

• Miocarditis: enfermedad inflamatoria del músculo cardiaco, que surge principalmente debido a la infección con virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology cardiotrópicos (comúnmente asociados con el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology Coxsackie, pero también se observa con el VEB).
• Arritmias (bradiarritmias y taquiarritmias) o pericarditis Pericarditis Pericarditis is an inflammation of the pericardium, often with fluid accumulation. It can be caused by infection (often viral), myocardial infarction, drugs, malignancies, metabolic disorders, autoimmune disorders, or trauma. Acute, subacute, and chronic forms exist. Pericarditis (inflamación del pericardio): pueden observarse junto con la miocarditis.

Dermatológicas

• Erupción asociada a la ampicilina
• Leucoplasia vellosa oral: desencadenada por el EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus; da lugar a parches blancos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la lengua que pueden tener un aspecto velloso

Hematológicas

• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica:
  • Tipo de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types causada por la destrucción prematura de los LOS Neisseria glóbulos rojos.
  • La anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica autoinmune fría es una complicación poco frecuente que puede estar asociada al AL Amyloidosis VEB.
• Trombocitopenia y/o neutropenia Neutropenia Neutrophils are an important component of the immune system and play a significant role in the eradication of infections. Low numbers of circulating neutrophils, referred to as neutropenia, predispose the body to recurrent infections or sepsis, though patients can also be asymptomatic. Neutropenia: complicación relacionada con la producción de anticuerpos contra plaquetas y/o neutrófilos durante la infección por VEB.

Hepáticas

• Síndrome de Reye: trastorno poco frecuente caracterizado por encefalopatía e insuficiencia hepática tras la recuperación de una infección vírica (afecta principalmente a niños).
• Hepatitis vírica leve: infección que causa inflamación y lesiones hepáticas
• Necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage hepática fulminante: lesión grave del hígado asociada a encefalopatía e INR prolongado ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum un individuo sin enfermedad hepática subyacente)

Esplénicas

• Esplenomegalia
• Rotura esplénica:
  • Ocurre en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 0.1%–0.5% de los LOS Neisseria casos; más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hombres.
  • Se presenta con:
    • Dolor Dolor Inflammation abdominal brusco
    • Dolor Dolor Inflammation referido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hombro
    • Compromiso hemodinámico
  • Requiere evaluación quirúrgica urgente; el manejo no quirúrgico se utiliza cada vez más en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes hemodinámicamente estables.
  • Evitar deportes de contacto y levantar objetos pesados puede reducir el riesgo.

Respiratorias

• Obstrucción de las vías respiratorias por inflamación amigdalina y faríngea grave (se maneja con protección de la vía aérea, interconsulta con otorrinolaringología y corticosteroides sistémicos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casos graves)
• Neumonitis intersticial
• Neumonía

Inmunológicas y oncológicas

• Disminución de la inmunidad celular
• Síndromes linfoproliferativos
• Linfomas de Burkitt y no Hodgkin:
  • Asociados a la infección por EBV EBV Epstein-barr virus (EBV) is a linear, double-stranded DNA virus belonging to the herpesviridae family. This highly prevalent virus is mostly transmitted through contact with oropharyngeal secretions from an infected individual. The virus can infect epithelial cells and B lymphocytes, where it can undergo lytic replication or latency. Epstein-Barr Virus.
  • El linfoma de Burkitt endémico ocurre principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum África ecuatorial y se asocia con coinfección por malaria Malaria Malaria is an infectious parasitic disease affecting humans and other animals. Most commonly transmitted via the bite of a female Anopheles mosquito infected with microorganisms of the Plasmodium genus. Patients present with fever, chills, myalgia, headache, and diaphoresis. Plasmodium/Malaria; afecta típicamente la mandíbula y los LOS Neisseria huesos faciales.
  • El linfoma de Burkitt esporádico se presenta con masas abdominales o afectación de la médula ósea.
• Linfomas de Hodgkin: cáncer que se origina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria linfocitos y que se manifiesta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de ganglios linfáticos no dolorosos y agrandados en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuello, bajo el brazo o en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la ingle
• El carcinoma nasofaríngeo y el carcinoma gástrico asociado al AL Amyloidosis VEB también están vinculados a la infección por VEB.
• Esclerosis múltiple: grandes estudios epidemiológicos han establecido la infección por VEB como un factor de riesgo necesario (aunque no suficiente) para la EM.

Neurológicas

• Encefalitis: inflamación del cerebro, causada generalmente por una infección viral
• Síndrome de Guillain-Barré: una polineuropatía autoinmune (debilidad de las extremidades, neuropatías craneales, cambios sensoriales) que se produce después de una infección.
• Otras complicaciones:
  • Parálisis de Bell (parálisis del nervio facial)
  • Neuritis óptica
  • Mielitis transversa
  • Linfoma primario del SNC

Renales

• Glomerulonefritis: la inflamación postinfecciosa de los LOS Neisseria glomérulos se asocia ocasionalmente al AL Amyloidosis VEB.
• Nefritis intersticial:
  • Inflamación del intersticio renal.
  • Suele estar inducida por la ingesta de fármacos, pero también se observa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum infecciones bacterianas, víricas y fúngicas.

Diagnóstico Diferencial

Las siguientes condiciones son diagnósticos diferenciales para la mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis infecciosa:

• Infección por CMV: un virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de ADN de doble cadena que se propaga por secreciones como la saliva Saliva The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptyalin. Salivary Glands: Anatomy, la orina y la sangre. La infección por CMV suele ser asintomática en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria huéspedes inmunocompetentes, pero causa una enfermedad grave en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria pacientes inmunocomprometidos.
• Infección por VIH: está causada por un virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de ARN monocatenario de la familia Retroviridae Retroviridae The human immunodeficiency virus (HIV) is a species of Lentivirus, a genus of the family Retroviridae, which causes HIV infections and acquired immunodeficiency syndrome (AIDS). The virus has high genetic variability and is divided into 2 major types, HIV type 1 (HIV-1) and HIV type 2 (HIV-2). The human immunodeficiency virus is a single-stranded, positive-sense, enveloped RNA virus, which targets and destroys WBCs, leading to frequent opportunistic infections and, eventually, death. Human Immunodeficiency Virus (HIV) y se transmite a través del intercambio de fluidos corporales, como el semen y la sangre. La infección por el VIH provoca un deterioro del sistema inmunitario, que comienza con síntomas constitucionales (linfadenopatía) y avanza hacia las enfermedades características del SIDA (infecciones oportunistas).
• Infección estreptocócica: bacteria Bacteria Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases. Bacteriology grampositiva conocida por su característico crecimiento en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cadena; puede causar endocarditis Endocarditis Endocarditis is an inflammatory disease involving the inner lining (endometrium) of the heart, most commonly affecting the cardiac valves. Both infectious and noninfectious etiologies lead to vegetations on the valve leaflets. Patients may present with nonspecific symptoms such as fever and fatigue. Endocarditis, meningitis Meningitis Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. The causes of meningitis are varied, with the most common being bacterial or viral infection. The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis, conjuntivitis bacteriana y fascitis necrosante
• Toxoplasmosis Toxoplasmosis Toxoplasmosis is an infectious disease caused by Toxoplasma gondii, an obligate intracellular protozoan parasite. Felines are the definitive host, but transmission to humans can occur through contact with cat feces or the consumption of contaminated foods. The clinical presentation and complications depend on the host’s immune status. Toxoplasma/Toxoplasmosis: enfermedad infecciosa causada por Toxoplasma Toxoplasma Toxoplasmosis is an infectious disease caused by Toxoplasma gondii, an obligate intracellular protozoan parasite. Felines are the definitive host, but transmission to humans can occur through contact with cat feces or the consumption of contaminated foods. The clinical presentation and complications depend on the host’s immune status. Toxoplasma/Toxoplasmosis gondii, que es un parásito intracelular obligado que vive en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el intestino felino (huésped definitivo). Los LOS Neisseria seres humanos pueden infectarse a través del consumo de carne cruda o de alimentos contaminados por heces de gato.
• Virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de la parainfluenza: virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de ARN con envoltura que pueden causar infecciones de las vías respiratorias superiores e inferiores y crup, que suelen presentarse como mialgias/artralgias repentinas con fiebre y amigdalitis
• Difteria: infección bacteriana grave causada por Corynebacterium diphtheriae Corynebacterium diphtheriae Diphtheria is an infectious disease caused by corynebacterium diphtheriae that most often results in respiratory disease with membranous inflammation of the pharynx, sore throat, fever, swollen glands, and weakness. The hallmark sign is a sheet of thick, gray material covering the back of the throat. Diphtheria que afecta a las membranas mucosas de la nariz y la garganta, provocando dolor Dolor Inflammation de garganta, fiebre, inflamación de los LOS Neisseria ganglios y debilidad
• Herpesvirus humano (HHV): síndrome similar a la mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis infecciosa que se asocia a la seroconversión del HHV-6 HHV-6 Human herpesvirus (HHV)-6 and HHV-7 are similar double-stranded DNA viruses belonging to the Herpesviridae family. Human herpesviruses are ubiquitous and infections are commonly contracted during childhood. Human Herpesvirus 6 and 7 en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adultos. Aunque se trata de una afección poco frecuente, los LOS Neisseria síntomas se asocian a linfadenopatía anterior y posterior.