199.4 📌 章末速蚘

  • EBV: dsDNA herpesvirus, B cells + epithelial cells, lifetime latency
  • Universal infection (95%+ adults)
  • IM (kissing disease): fever + pharyngitis + posterior cervical LAP + splenomegaly + atypical lymphocytes + monospot+
  • Amoxicillin rash in EBV = pathognomonic (NOT allergy)
  • Contact sports avoidance × 3-4 wk (splenic rupture)
  • Cancer associations: Burkitt, NPC (Taiwan!), gastric, Hodgkin, NK/T-cell, PTLD, primary CNS lymphoma in HIV
  • 2022 game changer (Bjornevik et al.): EBV strongly associated with MS — necessary trigger
  • XLP: SH2D1A → fulminant IM + lymphoma
  • PTLD: reduce immunosuppression + rituximab + EBV-specific T cells
  • Treatment: supportive for IM; no antiviral (acyclovir minimal effect); steroid only for complications
  • Plasma EBV DNA = NPC prognostic biomarker (Taiwan endemic)
  • 盧醫垫 hint: 老幎 + 䞍明 LAP + Taiwan/Asia → NPC ALWAYS; EBV PCR + 圱像 + biopsy