Please be patient! It may take up to ONE minute to load all the Engines.
Problems? Please contact our support.
Alternative namesInfectious mononucleosis; Mono; Kissing disease; Epstein-Barr viral syndrome
DefinitionMononucleosis is a viral infection causing fevers, sore throat, and swollen lymph glands, especially in the neck. It is typically caused by the Epstein-Barr virus (EBV), but can also be caused by other organisms such as cytomegalovirus (CMV). Both viruses are members of the herpesvirus family.
Causes, incidence, and risk factors
Mononucleosis is often transmitted by saliva. While it is known as "the kissing disease," occurring most often in 15- to 17-year-olds, the infection may occur at any age.
Mono 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 covering. The lymph nodes in the neck are frequently enlarged and painful.
A pink, measles-like rash can occur and is more likely if the patient is given ampicillin or amoxicillin for a throat infection. (Antibiotics should NOT be given without a positive strep test.) The symptoms of mono gradually subside on their own over a period of weeks to months.
Chronic EBV infection may be associated with some rarer types of cancer. In Africa, for example, EBV is associated with Burkitt's lymphoma . In organ transplant patients, it can cause post-transplant lymphoproliferative disease (PTLD), a type of lymphoma.
Less frequently occurring symptoms include:
Signs and tests
During a physical examination, the doctor may find enlarged lymph nodes in the front and back of the neck, as well as swollen tonsils with the whitish covering. The doctor might also find an enlarged liver or enlarged spleen when pushing on your belly. There may be a skin rash present.
Laboratory findings often include an elevated white blood cell count, and the characteristic finding of atypical lymphocytes -- unusual-appearing white blood cells that are seen when blood is examined under a microscope. Abnormal liver function tests are also characteristic.
Common tests for EB include:
Most patients recover within 2-4 weeks without medication. Younger children often don't have symptoms, while some older patients may have fatigue for up to 6 weeks.
There is no specific treatment available. Antiviral medications do not help. Steroid medication may be considered for patients with severe symptoms.
To relieve typical symptoms:
The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Fatigue usually resolves within a few weeks, but may linger for 2 to 3 months.
Calling your health care provider
The initial symptoms of mono feel very much like a typical viral illness. It is not necessary to contact a health care provider unless symptoms last longer than 10 days or you develop the following:
If any of these symptoms occur, you should be evaluated by your health care provider immediately or call 911.
The infection is probably spread by saliva and close contact. People may be contagious while they have symptoms and for up to a few months afterwards. The virus can live for several hours outside the body. Avoid kissing or sharing utensils if you or someone close to you has mono. The exact period that people are contagious varies.
Update Date: 11/12/2003Steven Angelo, M.D., Assistant Professor of Medicine, Yale School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT