What does it consist of? Also called mononucleosis, it is a very common disease caused by the virus or the Epstein-Barr strain.
When most people reach adulthood, an antibody against the virus can be detected in their blood which means they have been infected. The disease is less severe in young children.
The infection can be spread by saliva. The incubation period of mononucleosis is 4 to 8 weeks. Symptoms include fever, fatigue, sore throat and swollen lymph nodes.
It can cause liver inflammation (hepatitis) and enlargement of the spleen. Vigorous contact sports should be avoided to prevent rupture of the spleen.
Infectious mononucleosis is a contagious disease. Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis, but other viruses can also cause this disease.
It is common among teenagers and young adults, especially college students. At least one in four adolescents and young adults who become infected with EBV will develop infectious mononucleosis.
The common symptoms of mononucleosis usually appear four to six weeks after contact with the strain. Symptoms can develop slowly and not all can occur at the same time.
These symptoms include:
- Liver or swollen spleen or both.
- Extreme fatigue
- Inflammation of the lymph nodes in the neck and armpits.
- Sore throat.
- Pains in the head and body.
The enlarged spleen is one of the less common symptoms. For some people, their liver or spleen or both may remain enlarged even after the disease goes away.
Most patients improve in two or four weeks; Some patients may feel fatigued for several more weeks. Occasionally, the symptoms of infectious mononucleosis may last six months or longer.
The EBV virus is the most common cause of infectious mononucleosis, but other viruses can cause this disease. Typically, these viruses are most commonly spread through body fluids, especially saliva.
However, these viruses can also spread through blood and semen during sexual contact, blood transfusions and organ transplants.
Prevention and Treatment
There is no vaccine to protect against infectious mononucleosis. You can help protect yourself by not kissing or sharing drinks, food or personal items, such as toothbrushes, with people who have infectious mononucleosis.
You can help relieve the symptoms of infectious mononucleosis by:
- Drink fluids to keep the body hydrated.
- Rest a lot.
- Take over-the-counter medications for pain and fever.
- If you have infectious mononucleosis, you should not take ampicillin or amoxicillin.
- Based on the severity of the symptoms, a healthcare provider may recommend treatment of specific organ systems affected by infectious mononucleosis.
- Because your spleen can become enlarged as a result of infectious mononucleosis, you should avoid contact sports until you recover completely.
- Participating in contact sports can be strenuous and can cause the spleen to break.
Diagnosis of infectious mononucleosis
Health care providers typically diagnose infectious mononucleosis based on symptoms.
Laboratory tests are usually not necessary to diagnose infectious mononucleosis.
However, specific laboratory tests may be necessary to identify the cause of the disease in people who do not have a typical case of infectious mononucleosis.
Blood screening of patients who have infectious mononucleosis due to EBV infection may show:
- More white blood cells (lymphocytes) than normal.
- White blood cells of unusual appearance (atypical lymphocytes).
- Less than normal neutrophils or platelets.
- Abnormal liver function
Infectious mononucleosis is caused by the Epstein-Barr virus (EBV, human herpesvirus type 4) and is characterized by fatigue, fever, pharyngitis and lymphadenopathy. Fatigue may persist for weeks or months.
Occasionally, serious complications occur, including obstruction of the respiratory tract, splenic rupture, and neurological syndromes. The diagnosis is clinical or with serological tests. The treatment is supportive.
Although recovery is usually complete, the complications can be dramatic.
Neurological complications are rare, but may include encephalitis, seizures, Guillain-Barré syndrome, peripheral neuropathy, viral meningitis, myelitis, cranial nerve palsy, and psychosis.
Encephalitis can manifest with cerebellar dysfunction, or it can be global and rapidly progressive, similar to herpes simplex encephalitis, but it is usually self-limiting.
Hematological complications are usually self-limiting. They include:
- Hemolytic anemia.
Granulocytopenia or mild transient thrombocytopenia occurs in approximately 50% of patients.
Severe cases, associated with bacterial infection or bleeding, occur less frequently. Hemolytic anemia is often due to cold agglutinin-specific anti-i antibodies.
Splenic rupture can have serious consequences. It can result from splenic enlargement and capsular swelling, which are maximum 10 to 21 days after presentation.
A history of trauma is present only half the time. The rupture is usually painful, but occasionally causes painless hypotension.
Respiratory complications include, rarely, obstruction of the upper respiratory tract due to pharyngeal or paratracheal lymphadenopathy; Respiratory complications can respond to corticosteroids.
Clinically silent interstitial pulmonary infiltrates occur mainly in children and are usually visible on radiographs.
Liver complications include elevation of aminotransferase levels (approximately 2 to 3 times normal, returning to baseline more than 3 to 4 weeks), which occur in about 95% of patients.
If jaundice or more severe elevations of the enzyme occur, other causes of hepatitis should be investigated.
Serious EBV infection occurs sporadically, but can be grouped in families, particularly those with X-linked lymphoproliferative syndrome.
Survivors of primary EBV infection are at risk of developing agammaglobulinemia or lymphoma.
Infectious mononucleosis is usually self-limiting. The duration of the disease varies; The acute phase lasts about 2 weeks. In general, 20% of patients can return to school or work in 1 week, and 50% in 2 weeks.
Fatigue may persist for several more weeks or, in 1 to 2% of cases, for months.
Death occurs in <1%, mainly due to complications (eg, encephalitis, splenic rupture, obstruction of the airways).