MONONUCLEOSIS

Infectious mononucleosis may begin slowly with fatigue, malaise, headache, and sore throat. The sore throat becomes progressively worse, often with enlarged tonsils covered with a whitish-yellow fibrinous exudate. The lymph nodes in the neck are frequently enlarged and painful. A pink measles-like rash may occur in approximately 1 out of 10 individuals with mono.

What is Mononucleosis?

An acute viral infection causing high temperature, sore throat, and swollen lymph glands, especially in the neck. It is typically caused by the Epstein-Barr virus, but can also be caused by the cytomegalovirus (CMV).

Mononucleosis caused by EBV is the most frequently encountered type and is responsible for approximately 85% of infectious mononucleosis cases. The infection is often transmitted by saliva. While peak incidence occurs in 15- to 17-year-olds, the infection may occur in any age, being most often diagnosed between the ages of 10 and 35.

How is Mononucleosis Prevented?

Infectious mononucleosis can be contagious when in close or intimate contact with an infected person. Since the infection is probably spread by saliva, kissing or other transfer of oral secretions should be avoided.

What are the Common Symptoms of Mononucleosis?

  • fever
  • sore throat
  • enlarged lymph nodes, especially in the neck and axilla (armpit)
  • facial swelling
  • general discomfort, uneasiness, or ill feeling (malaise)
  • drowsiness
  • loss of appetite
  • muscle aches or stiffness
  • enlarged spleen
  • rash

How is Mononucleosis Diagnosed?

A physical examination reveals an enlarged liver and (or) enlarged spleen. The liver and spleen may be tender when they are gently pressed (palpation). There may be a skin rash present. Laboratory findings often include such characteristic findings as atypical lymphocytes, which are unusual appearing white blood cells that are seen when the blood is examined under a microscope. This sign may persist for 2 to 8 weeks. Abnormalities of liver function are also characteristic. Common tests for EB include a monospot test (positive for infectious mononucleosis) and a Epstein-Barr virus antigen by immunofluorescence (positive for EBV).

What is the Treatment for Mononucleosis?

Most patients recover within 4 to 6 weeks without medication. There is no specific treatment available. Antiviral medications do not help. Rest is needed, sometimes for a month or longer.

Relieve pain and fever with analgesics, and use warm salt water gargles for sore throat. A high protein, decreased fat diet and vitamin supplements may be recommended. Contact sports should be avoided while the spleen is enlarged.

» top