Infectious Mononucleosis- This is a medical condition caused by the Epstein Barr Virus which has the ability to affect any part of body. Infectious Mononucleosis may lead to inflammation of the liver as well as spleen enlargement. Spontaneous rupture of the spleen in symptomatic and asymptomatic patient is been found to be caused by infectious mononucleosis.1 In this article, we will discuss in detail about the causes, symptoms, and various treatments rendered for Infectious Mononucleosis.

Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease

How Is Infectious Mononucleosis Defined?

  • Infectious Mononucleosis is also known by the name of Mono or the Kissing Disease is a pretty common infection, which is caused by the Epstein-Barr virus.
  • The main symptoms of Mononucleosis infection caused by the Epstein Barr virus are fever, fatigue, and sore throat.2
  • The reason why this infection is termed as Mononucleosis is because of the fact that it refers to an increase in a certain type of mononuclear lymphocytes in bloodstream in comparison to other white blood cells due to the infection.

Causes of Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease

  • The virus that is responsible for causing Infectious Mononucleosis is present almost all over the world.
  • It is also estimated that people who are more prone to get Infectious Mononucleosis are between the age group of 15-25.3
  • It is estimated that in the United States, more than 90% of people have been found to have Epstein Barr Virus antibody.
  • Presence of antibodies in the blood suggests individual has been infected in the past.

Facts About Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease

  • Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease is a contagious medical condition, which is caused by Epstein-Barr virus.
  • This infection tends to spread by saliva.
  • Most adults have been found to have antibodies for EBV.
  • Some of the symptoms of Infectious Mononucleosis are fever, malaise, sore throat, lymph node swelling.
  • Confirmatory diagnosis of Infectious Mononucleosis is made following blood examination.2
  • Infectious Mononucleosis can result in inflammation of liver and spleen enlargement.2
  • It is recommended that any individual identified to have spleen enlargement due to Infectious Mononucleosis should avoid any form of contact sports in order to prevent rupture of spleen.3

Risk Factors for Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease

The Epstein Barr virus has the potential to infect any individual. As stated before, this virus at some point in life has already infected majority of population by the time they reach an age of about 30. People who are in the age range of 15-25 are more prone to get this infection. There are some instances where Infectious Mononucleosis is found even in children.

Symptoms Of Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease

Non-Specific Symptoms Of Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease Are As Follows-

  • Lack of energy
  • Fatigue
  • Appetite loss

Specific Symptoms Of Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease Are-

  • Extremely severe sore throat
  • Enlarged tonsils
  • Constant fever
  • Enlarged lymph nodes
  • Enlarged spleen
  • Occasionally, in 5% of the cases measles like rash may be observed for 3 to 5 days.

Diagnosis of Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease

  • Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease is suspected if an individual presents with the above mentioned symptoms. Similar symptoms are often seen with several other diseases.
  • Infectious Mononucleosis is confirmed by blood tests.
  • In the early stages of the infection, the blood test will show an elevation of lymphocyte count and larger sized mono cells.
  • The characteristic finding of mononucleosis is the positive Monospot test and the Heterophile Antibody Test, which suggests presence of antibodies in the blood.
  • Apart from these tests, a chemistry panel may reveal liver function abnormalities.
  • The diagnosis of mono is suspected by the doctor based on the above symptoms and signs in the presence of abnormal lab test.
  • Ultrasound examination of spleen to evaluate splenomegaly (enlarge spleen).4

Treatment for Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease

  • Fever, headache and body aches are treated with Tylenol.
  • Majority of cases of Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease do not require treatment.
  • Infectious Mononucleosis is basically a self-limiting infection and resolves on its own.
  • Treatment is basically directed towards relief of symptoms such as fever, muscle aches and loss of appetite.
  • Antiviral medications are often prescribed to treat high fever and swelling of the tonsils.
  • Corticosteroids are prescribed for enlarged tonsils causing obstruction of airway and breathing difficulties.
  • Antibiotics should not be prescribed for viral infection like mononucleosis.
  • Avoid antibiotics like erythromycin, ampicillin and amoxicillin for strep throat cause by Infectious Mononucleosis (Mono) or Glandular Fever or Kissing Disease.

Patients can continue to have virus particles present in their saliva for as long as 18 months after the initial infection. When symptoms persist for more than six months, the condition is frequently called "chronic" EBV infection. However, laboratory tests generally cannot confirm continued active EBV infection in people with "chronic" EBV infection.

References:

1. Infectious mononucleosis presenting as spontaneous splenic rupture without other symptoms.

Stockinger ZT.

Mil Med. 2003 Sep;168(9):722-4.

2. Infectious mononucleosis: return to play.

Auwaerter PG.

Clin Sports Med. 2004 Jul;23(3):485-97, xi.

3. Infectious mononucleosis and the spleen.

Kinderknecht JJ.

Curr Sports Med Rep. 2002 Apr;1(2):116-20.

4. Return to contact sports following infectious mononucleosis: the role of serial ultrasonography.

O'Connor TE1, Skinner LJ, Kiely P, Fenton JE.

Ear Nose Throat J. 2011 Aug;90(8):E21-4.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: September 21, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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