Epstein-Barr (EBV) infection

infectious mononucleosis

Kissing disease

May present with Bell's palsy (HSV, EBV and Lyme are associated with facial palsy)

EBV commonly infects B cells, stimulating them to enter the cell cycle and proliferate continuously ("transformation" or "immortalization").

This is accomplished when EBV-encoded oncogenes activate proliferative and anti-apoptotic signaling pathways within the infected B cell.

In an immunocompetent host, a vigorous immune response holds EBV-induced B cell proliferation in check.

The immortalized B cells maintain the ability to secrete immunoglobulins and B-cell activation products (eg, CD23), with very few of them releasing virus particles at any one time.

Nasopharyngeal carcinoma and Burkitt's lymphoma t8:14

Hodgkin's lymphoma (Reed-sternberg cells) are associated with EBV. (particularly in Asian population)

Oral Hairy leukoplakia in HIV patients, non-cancerous

cannot scrape as in Candida thrush.

lymphoproliferative disease in transplant patients

EBV envelope glycoprotein binds CD21 to infect B cells

and stimulate reactive cytotoxic CD8+ T cells (as Downey, or atypical cells seen on blood smear ),

The immune response is triggered by CD8+ Tcells (NOT B cells),

So, hyperplasia seen in Paracortex (T cell region) of lymph nodes;

In spleen --> periarterial lymphatic sheath of white pulp