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Corticosteroids often used in treatment of infectious mononucleosis
October 18, 2005CHICAGO - Corticosteroids are used often in the treatment of infectious mononucleosis, and for reasons beyond usual criteria, according to a study in the October issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.
Systemic corticosteroid therapy (SCT) in the treatment of infectious mononucleosis has long been controversial, with conflicting results from different studies, according to background information in the article. The most consistently agreed on indication for SCT in the treatment of mononucleosis has been for complications involving severe airway compromise.
Scott K. Thompson, M.D., of the University of Rochester Medical Center, Rochester, N.Y., and colleagues analyzed the records of patients diagnosed with infectious mononucleosis from January 1998 to March 2003. Details of each patient's symptoms at the first visit, diagnosis, treatment and outcome were analyzed.
Systemic corticosteroid therapy was used in 44.7 percent of patients (92 of the 206 individuals included in the analysis), the researchers report. Evaluation of treatment indications for SCT showed that 8.0 percent of the study population qualified by traditional criteria for the use of corticosteroids, seven patients for "airway concern" and one patient for another indicated complication. "Factors associated with the observed increase in corticosteroid use included a history of repeat visits, inpatient admission, and otolaryngology consultation," the authors write.
"Despite consistent and uniform acceptance in the medical literature that SCT in the setting of IM [infectious mononucleosis] should be reserved for patients with impending airway obstruction, corticosteroids continue to be used on a much broader scale at this tertiary care institution," the authors conclude. "This observation suggests that clinicians see value in SCT for treatment of IM beyond the classically accepted reasons. Moreover, despite previous reports of possible adverse consequences of SCT in IM, our review failed to demonstrate any such trend."
JAMA and Archives Journals
Systemic corticosteroid therapy was used in 44.7 percent of patients (92 of the 206 individuals included in the analysis), the researchers report. Evaluation of treatment indications for SCT showed that 8.0 percent of the study population qualified by traditional criteria for the use of corticosteroids, seven patients for "airway concern" and one patient for another indicated complication. "Factors associated with the observed increase in corticosteroid use included a history of repeat visits, inpatient admission, and otolaryngology consultation," the authors write.
"Despite consistent and uniform acceptance in the medical literature that SCT in the setting of IM [infectious mononucleosis] should be reserved for patients with impending airway obstruction, corticosteroids continue to be used on a much broader scale at this tertiary care institution," the authors conclude. "This observation suggests that clinicians see value in SCT for treatment of IM beyond the classically accepted reasons. Moreover, despite previous reports of possible adverse consequences of SCT in IM, our review failed to demonstrate any such trend."
JAMA and Archives Journals
Mononucleosis Current Events and Mononucleosis News RSSUCSF researchers identify new drug target for Kaposi's Sarcoma
UCSF researchers have identified a new potential drug target for the herpes virus that causes Kaposi's sarcoma, re-opening the possibility of using the class of drugs called protease inhibitors against the full herpes family of viruses, which for 20 years has been deemed too difficult to attain.
Study indicates that a common virus could cause high blood pressure
A new study suggests for the first time that cytomegalovirus (CMV), a common viral infection affecting between 60 and 99 percent of adults worldwide, is a cause of high blood pressure, a leading risk factor for heart disease, stroke and kidney disease.
Epstein-Barr Virus May Be Associated with Progression of MS
Epstein-Barr virus (EBV), the pathogen that causes mononucleosis, appears to play a role in the neurodegeneration that occurs in persons with multiple sclerosis, researchers at the University at Buffalo and the University of Trieste, Italy, have shown.
OHSU finds association between Epstein-Barr virus, inflammatory diseases of the mouth
Researchers at Oregon Health & Science University's School of Dentistry (www.ohsu.edu/sod) have found that a significant percentage of dental patients with the inflammatory diseases irreversible pulpitis and apical periodontitis also have the Epstein-Barr virus.
Vaccine shows promise in preventing mono
A new study suggests that a vaccine targeting Epstein-Barr virus (EBV) may prevent infectious mononucleosis, commonly known as "mono" or "glandular fever."
OHSU research suggests America may over-vaccinate
A new study published in the New England Journal of Medicine this week by Oregon Health & Science University researchers suggests that timelines for vaccinating and revaccinating Americans against disease should possibly be reevaluated and adjusted.
Epstein-Barr: a virtual look at a vexing virus
Researchers at Tufts University School of Medicine in collaboration with the Virginia Bioinformatics Institute at Virginia Tech have created a computer program called Pathogen Simulation (PathSim) to study the progression of Epstein-Barr virus (EBV) in humans.
An AIDS-related virus reveals more ways to cause cancer, Penn researchers find
Researchers at the University of Pennsylvania School of Medicine have shed new light on how Kaposi's Sarcoma-associated Herpes Virus (KSHV) subverts normal cell machinery to cause cancer.
Common blood test can help distinguish between mononucleosis and tonsillitis
Measuring a patient's ratio of white blood cell types may help physicians accurately distinguish between the similar conditions infectious mononucleosis and bacterial tonsillitis, potentially guiding treatment decisions.
New lab mice pave way for novel studies of human infection
A new type of laboratory mouse developed at UT Southwestern Medical Center can fight certain infections the same way humans do, making the rodents very useful for novel studies of human-pathogen interaction and developing disease therapies.
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