Enfermedad de los Legionarios d. La historia de quimioterapia o radioterapia previas pueden asociarse a mielodisplasia o leucemias agudas secundarias que se pueden presentar como pancitopenia. La saciedad temprana con molestias en el abdomen superior pueden ser indicativos de esplenomegalia que puede causar hiperesplenismo. Estudios de laboratorio Antes de alarmar al paciente, repita el hemograma si se sospecha pancitopenia. La mayor sensibilidad, corresponde a las muestras de bazo, pero por la posibilidad de complicaciones, no es el material analizado habitualmente. Los anticuerpos antileishmania pueden estar elevados en pacientes inmunocompetentes con leishmaniasis visceral.

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Clarify the frequency and the pathophysiological mechanisms of the rare manifestations of Epstein—Barr virus infection. Original research studies published in English between and were selected through a computer-assisted literature search PubMed and Scopus.

Computer searches used combinations of key words relating to "EBV infections" and "atypical manifestation. The primary infection concerns mostly children and presents with the clinical syndrome of infectious mononucleosis. However, Epstein—Barr virus infection may exhibit numerous rare, atypical and threatening manifestations. It may cause secondary infections and various complications of the respiratory, cardiovascular, genitourinary, gastrointestinal, and nervous systems.

Epstein—Barr virus also plays a significant role in pathogenesis of autoimmune diseases, allergies, and neoplasms, with Burkitt lymphoma as the main representative of the latter.

The mechanisms of these manifestations are still unresolved. Therefore, the main suggestions are direct viral invasion and chronic immune response due to the reactivation of the latent state of the virus, or even various DNA mutations. Physicians should be cautious about uncommon presentations of the viral infection and consider EBV as a causative agent when they encounter similar clinical pictures.

Um paciente ocasional pode ter trombocitopenia por oito semanas ou mais. Houve mais de 6. Atypical manifestations of Epstein-Barr virus in children: a diagnostic challenge.

J Pediatr Rio J. Epstein-Barr virus in systemic autoimmune diseases. Clin Dev Immunol. Mononucleose infecciosa. Mononucleosis and Epstein-Barr virus infection: treatment and medication. Acute dacryocystitis associated with Epstein-Barr virus infec-tion. Upperairway obstruction in infectious mononucleosis. Eur J Emerg Med. Pleuropneumonia as the sole manifestation of Epstein-Barr virus-associated infectious mononucleosis. Isr Med Assoc J. Trapani FF, Viale P.

Myopericarditis during a primary Epstein-Barr virus infection in an otherwise healthy young adult. An unusual and insidious complication. Case report and a year literature review. Infez Med. Viral causes of human myocarditis. Arch Cardiovasc Dis. Viruses and stherosclerosis. New York: Springer; Evidence for the role of Epstein-Barr virus infecti-ons in the pathogenesis of acute coronary events.

Epstein--Barr virus-induced gene-3 is expressed in human atheroma plaques. Am J Pathol. Life-threatening thrombocyto-penia associated with acute Epstein-Barr virus infection in an older adult. Ann Hematol. Acute Epstein-Barr virus infection complicated by severe thrombocytopenia.

Clin Infect Dis. EBV infection resul-ting in aplastic anemia: a case report and literature review. J Blood Disord Transfus. Mase S, et al. Agranulocytosis after infectious mononucleosis. J Clin Virol. Viral infecti-ons associated with haemophagocytic syndrome. Rev Med Virol. Infectious mononucleosis. N Engl J Med. Systemic Epstein-Barr virus infection associated with membra-nous nephropathy in children.

Clin Nephrol. Acute interstitial nephritis secondary to infectious mononucleosis. Genital ulcers as initial manifestation of Epstein-Barr virus infection: two new cases and a review of the literature. Acta Derm Venereol. Genital ulcers associated with Epstein-Barr virus. Genitourinary manifestationsof Epstein-Barr virus infections. Curr Infect Dis Rep. Epstein-Barr virus hepatitis: case series and review. South Med J.

Epstein-Barr virus-associated acute acalculous cholecystitis: a rare occurrence but favorable outcome. Clin Pediatr Phila. Dig Dis Sci. Liver transplantation in children. Nonoperative management of sponta-neous splenic rupture in infectious mononucleosis: a case report and review of the literature.

Bilateral facial nerve palsy associated with Epstein-Barr virus infection with a review of the literature. Scand J Infect Dis. Neurological picture. Bilateral facial nerve palsy associated with Epstein--Barr virus infection. J Neurol Neurosurg Psychiatry. Yuki N. Lancet Infect Dis. Pediatric Epstein-Barr virus-associated encephalitis: year review. J Child Neurol. The neuroanatomic localization of Epstein-Barr virus encephalitis may be a predic-tive factor for its clinical outcome: a case report and review of cases in 28 reports.

Alice in Wonderland syndrome. Arch Soc Esp Oftalmol. The Alice in Wonderland syndrome. Prog Brain Res. Alice in Wonderland'syndrome and infectious mononucleosis in children. Alice in Wonderland syndrome as an initial manifestation of Epstein-Barr virus infection. Br J Ophthalmol. Childhood Epstein-Barr virus infection and subsequent risk of psychotic experiences in adolescence: a population-based pros-pective serological study.

Schizophr Res. Risk and pre-dictors of fatigue after infectious mononucleosis in a large primary-care cohort. Meta-analysis of infectious agents and depression. Sci Rep.

Holm0y T. Epstein-Barr virus in systemic lupus erythematosus, rheuma-toid arthritis and multiple sclerosis - association and causation. Hypersensitivity to mosquito bites: a unique pathoge-nic mechanism linking Epstein-Barr virus infection, allergy and oncogenesis.

J Dermatol Sci. The need and challenges for development of an Epstein-Barr virus vaccine. Viruses associated with human cancer. Biochim Biophys Acta. Epstein-Barr virus in Burkitt's lymphoma: a role for latent mem-brane protein 2A. Cell Cycle. Oncoge-nic mechanisms in Burkitt lymphoma. Cold Spring Harb Perspect Med. Deficiency of the proapoptotic SAP function in X-linked lymphoproliferative disease aggravates Epstein-Barr virus EBV induced mononucleosis and promotes lymphoma development.

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