House S08EP16 “Gut Check”

House and Taub sneer at Universal Precautions!

Another Monday, and another episode of House, at least for a few more weeks as the series winds down. A timely episode this evening, what with the hockey playoffs starting up, as a minor league hockey player coughs up blood on the ice, landing him into Princeton Plainsboro. Also, Wilson drops a bomb onto House. For those of you who didn’t see the promo after last week’s episode, it apparently involves Wilson’s son. Is this a case of Wilson pranking House? Find out Monday night at 9 PM!

Back on Tuesday AM with the recap and diagnosis. Wilson’s paternity scare ended up not being Wilson’s prank on everyone, but of course was House pranking Wilson, “in order to teach him a lesson.” I’m reminded of the running gag on Arrested Development, where all of the major characters took turns using emotional blackmail, in order to teach the lesson that you shouldn’t try to teach someone a lesson. All’s good by the end, and we revert to Wilson’s status quo–no relationship, no children.

Our hockey player (Bobby) exhibited a number of signs and symptoms through the episode, including coughing up blood, an enlarged spleen, enlarged breasts, liver dysfunction, and paralysis of his extremities.  Their penultimate diagnosis is that he has somehow acquired botulism, and begin treating him using artificial passive immunization by administering botulinum antitoxin, however his condition does not resolve. The team later concludes that Bobby has Epstein Barr Virus, an ubiquitous virus that causes a number of related diseases in humans.

It is estimated that up to 95% of US adults have been infected with EBV at some point in their lives. Overt infection in children leads to infectious mononucleosis, or “mono,” a contagious infection that results in a number of general virus-associated signs of disease. Generally the immune system is able to bring the disease under control, however steroid treatments may help to relieve some of the symptoms. Complications due to EBV infection are rare, but happened to the patient in this episode of House.  There is no cure or vaccine for EBV infection, and treatments are designed for management of pain and fever.


About ycpmicro

My name is David Singleton, and I am an Associate Professor of Microbiology at York College of Pennsylvania. My main course is BIO230, a course taken by allied-health students at YCP. Views on this site are my own.

Posted on April 9, 2012, in House Party!. Bookmark the permalink. 3 Comments.

  1. After finding out that EBV is a member of the herpes family of viruses, this makes a lot more sense to me. Although it’s characterized as one of the most common human viruses, I’ve never heard of it, as well as many people probably never have because their are few studies done on it, thus, few papers published for our educational enlightenment. But it’s not rare. Up to 95% of adults in the US, ages 35-40, have been infected with EBV at some point in their lives; they remain asymptomatic AND retain the ability to pass EBV onto anyone who comes into direct/intimate contact with their saliva (infectious mono is also known as “the kissing disease” as many of you already know.) Now, rarely does EBV cause more than a 1-2 month inconvenience with an infectious mono diagnosis, but who the hell wants to go through that? The CDC also shares that EBV causes infectious mono in YOUNG ADULTS (that’s us!) 35-40% of the time it’s transmitted. That’s almost half of the transmitted cases within the young adult population. Like many other herpesfamily viruses, there is no cure and no immunization against EBV. Once you contract it, the virus lies dormant in your throat and blood cells for the remainder of your life. The silver lining to that dark cloud is that reactivation of EBV in a person’s body rarely produces symptoms of illness in a patient who has already experienced the initial infectious mono diagnosis. In other words, the cells may decide to become active inside your body again, and you’ll be able to transmit EBV, you just won’t know it. Although extreeeeeemely rare, I find it noteworthy to mention that EBV can also lie dormant within immune system cells, and is the contributing factor to two rare forms of cancer: Burkitt’s lymphoma and nasopharyngeal carcinoma. Long gone are the days when “just kissing” someone was completely harmless!
    Source for all information:

    • In our discussion of viruses, we will go over some of the mechanisms by which some viruses are able to alter the genome of cells that they infect. One consequence of that alteration can be certain cancers.

  2. Would it be correct to assume that an example of this would be a virus causing cancer by gaining entry into a cell and subsequently causing a mutation to occur?

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