Mononucleosis is an acute infection by Epstein Barr virus. This virus has a worldwide geographical distribution.Humans become infected in early childhood or late adolescence. The 90% of adults have been exposed to the virus.
Epstein Barr virus is transmitted by oral secretions, by transfer of saliva during kissing. Therefore mononucleosis is also known as the “kissing disease”. It can also be transmitted by sharing utensils and drinking glasses of an affected person.
From the mouth, the virus spreads through the body through the bloodstream. The virus enters and infects mainly B lymphocytes of the immune system (they are a type of white blood cell). Mononucleosis is the body’s inflammatory response to infection by the virus.
Young children have few or no symptoms, and the infection can go undetected.
Teenagers and young adults have mononucleosis as a flower box. After an incubation period of 4 to 6 weeks, the symptoms are fatigue, weakness, fever (not too high), muscle aches, sore throat pharyngitis or inflammation of the tonsils, and lymph nodes. Lymphadenopathy or swollen glands, usually located in the neck, are painful and tender to palpation.
In half of the cases may have an enlarged spleen (splenomegaly called).
In 5% of cases appears a rash or rash on the arms and trunk. Typically appears after taking an antibiotic of the penicillin family, although it is not an allergic reaction.
The fever and sore throat usually last the first two weeks. Lymphadenopathy, splenomegaly and fatigue can last several weeks.
Most of mononucleosis heal spontaneously. The complications are rare and include, among others, bacterial superinfection of the initial pharyngitis or tonsillitis, hepatitis, ruptured spleen (complication serious or deadly), meningitis and some anemias.
The diagnosis of infectious mononucleosis by Epstein Barr virus is confirmed by blood tests:
Treatment is symptomatic. Rest is important during the first few weeks. No strenuous exercise is recommended during the first three months after infection, especially if there splenomegaly, it increases the risk of rupture of the spleen.
Recommended intake plenty of fluids to maintain good hydration.
It can give antipyretics for fever high or analgesics to relieve sore throat and sore neck nodes.
Corticosteroids are not indicated as symptomatic treatment entry.
Should be treated individually specific complications.
There is no need to isolate patients with mononucleosis. It is best not kissing, sharing cups or utensils or while the person is sick.
There is no vaccine.
10% of the mononucleosis are produced by another virus, cytomegalovirus. The clinical picture is the same.The only difference is that the heterophile antibody test is negative.