A 19-year-old college student presents with three weeks of fever, sore throat, posterior cervical lymphadenopathy and splenomegaly. Peripheral smear shows atypical lymphocytes. The heterophile antibody test is positive. He was given amoxicillin elsewhere and developed a widespread maculopapular rash. The causative agent establishes latency in which cell type?
- A CD8+ cytotoxic T lymphocytes
- B Macrophages via CD14 receptor
- C B lymphocytes via CD21 receptor ✓
- D Salivary gland epithelial cells
Correct answer: C. B lymphocytes via CD21 receptor
Explanation
Epstein-Barr virus causes infectious mononucleosis and binds CD21 (the complement receptor CR2) on resting C lymphocytes, where it establishes lifelong latent infection. The CD21 binding also explains transformation of C cells in vitro and its association with endemic Burkitt lymphoma. Distractor D describes the site of productive replication in oropharyngeal epithelium and salivary shedding, not the latency compartment. Atypical lymphocytes are activated CD8+ T cells responding to infected C cells.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.