Mononucleosis

About Mononucleosis

Infectious mononucleosis, commonly called mono, is caused by the Epstein Barr virus EBV in approximately 90 percent of cases. Other causes include cytomegalovirus CMV, HIV, and toxoplasmosis. EBV infects B lymphocytes and is transmitted through saliva, hence the nickname kissing disease. The disease is most common in adolescents and young adults aged 15 to 24. Symptoms include fever, sore throat, swollen lymph nodes particularly in the neck, fatigue, and enlarged spleen. The fatigue can be debilitating and last for weeks or months. Approximately 50 percent of EBV infections in adolescents result in mono symptoms, while EBV infection in young children is usually asymptomatic. Diagnosis is made through monospot heterophile antibody test, EBV specific antibodies, and complete blood count showing atypical lymphocytes. Treatment is supportive with rest, hydration, and over the counter pain and fever relievers. Clinicians commonly advise against contact sports for several weeks because of the risk of splenic rupture, which is rare, occurring in roughly 0.1 to 0.5 percent of cases. Sudden sharp pain in the upper left abdomen can indicate splenic rupture and is a medical emergency; call your local emergency number. Antibiotics are not helpful and amoxicillin causes a characteristic rash in EBV infection. EBV infects over 90 percent of adults worldwide and is associated with certain cancers Burkitt lymphoma, nasopharyngeal carcinoma, Hodgkin lymphoma and multiple sclerosis.