Mononucleosis
Introduction
Infectious mononucleosis (mono), or glandular fever, is often called the kissing disease. The label is only partly true. The virus that causes this disease is transmitted through saliva, so kissing can spread the virus, but so can coughing, sneezing, or sharing a glass or food utensil. Mononucleosis isn't as contagious as some other infections, such as the common cold.
The cause of mononucleosis is the Epstein-Barr virus, although similar signs and symptoms are sometimes caused by cytomegalovirus (CMV). Full-blown mononucleosis is most common in adolescents and young adults. Young children usually have minimal symptoms, and the infection often goes unrecognized. In lesser developed countries, mononucleosis is more frequently acquired at a young age, so classic signs and symptoms of mononucleosis aren't as common as they are in developed nations.
Mononucleosis usually isn't very serious, although the virus remains in your body for life. Most people have been exposed to the Epstein-Barr virus by the time they're 35 years old and have built up antibodies. They're immune and won't get mononucleosis again. Treatment mostly involves bed rest and getting adequate fluids.
Signs and symptoms
Signs and symptoms of mononucleosis may include:
- Fatigue
- Weakness
- Sore throat, perhaps a strep throat that doesn't get better with antibiotics
- Fever
- Swollen lymph nodes in your neck and armpits
- Swollen tonsils
- Headache
- Skin rash
- Loss of appetite
- Soft, swollen spleen
- Night sweats
In children between the ages of 4 and 15, the virus may cause a mild illness that resembles a common respiratory infection. In older adults, mononucleosis causes more severe signs and symptoms and lasts longer.
The virus typically has an incubation period of four to six weeks, although in young children this period is shorter. Signs and symptoms such as fever and sore throat usually lessen within a couple of weeks, although fatigue, enlarged lymph nodes and a swollen spleen may last for a few weeks longer.
Complications
Among significant complications of mononucleosis is enlargement of the spleen. In extreme cases, your spleen may rupture, causing sharp, sudden pain in the left side of your upper abdomen. If such pain occurs, seek medical attention immediately — you may need surgery.
Most people with mononucleosis have mild liver inflammation (hepatitis). A yellowing of your skin and the whites of your eyes (jaundice) occurs occasionally, usually in people older than 35. About half the people with mononucleosis have a low count of platelets, which are blood cells involved in clotting.
Less common complications
Mononucleosis can also result in the following less common complications:
- Anemia, a decrease in red blood cells and in hemoglobin, an iron-rich protein in red blood cells
- Inflammation of the heart
- Complications involving the nervous system (meningitis, encephalitis, seizures, Bell's palsy, Guillain-Barre syndrome)
- Swollen tonsils, leading to obstructed breathing
Treatment
There's no specific therapy available to treat infectious mononucleosis. Antibiotics don't work against viral infections such as mono. Treatment mainly involves bed rest and adequate fluid intake.
Occasionally, a streptococcal (strep) infection accompanies the sore throat of mononucleosis. You may also develop a sinus infection or an infection of your tonsils (tonsillitis). If so, you may need treatment with antibiotics for these accompanying bacterial infections.
Some people with mononucleosis who take ampicillin (Principen), amoxicillin (Amoxil, Trimox), or amoxicillin and clavulanate (Augmentin) antibiotics may develop a rash, but this doesn't mean that they're allergic to the antibiotic. If needed, other antibiotics that are less likely to cause a rash are available to treat infections that may accompany mononucleosis.
To ease some of your symptoms, such as swelling of your throat and tonsils, your doctor may prescribe a corticosteroid medication such as prednisone.
Prevention
Mononucleosis is believed to spread through saliva. If you're infected, you can help prevent spreading the virus to others by not kissing them and by not sharing food, dishes, glasses and utensils until several days after your fever has subsided and even longer, if possible.
The Epstein-Barr virus may persist in your saliva for months after the infection. If you've had mononucleosis, don't donate blood for at least six months after the onset of the illness.
There's no vaccine to prevent mononucleosis.
Informations obtained from National Institute of Health.