Infectious mononucleosisInfectious mononucleosis or mono is a disease caused by a virus known as Epstein-Barr virus (EBV). The disease can be acquired from asymptomatic carriers or from recently ill patients who may excrete the virus by coughing or sneezing. The virus can be transmitted by small droplets of saliva which can be inhaled by others. Sexual intercourse is another route of infection is adolescents. Blood transfusion and organ transplant are other less common modes of infection. Sharing of food or beverage from the same container can also result in transmission of the virus due to presence of infected saliva. Close person to person contact can also transmit the disease-hence infectious mononucleosis is also known as kissing disease. Symptoms and signs: The incubation period may vary from one to two months. The disease usually starts with malaise and poor appetite. After two to three days fever appears. Sore throat is very common. Enlargement of lymph nodes is another common finding-those in the neck are almost always affected though other groups of lymph nodes may also be involved. Most of the patients have enlarged spleen. Liver may also be enlarged in some patients. Rash may be seen in a few patients. Almost all patients given penicillin or amoxycillin develop rash. Swelling of eyelids may be observed in some patients. Laboratory findings: Early in the course of the disease number of white blood cells may be decreased. Later an increase in the number of lymphocytes which look somewhat different from normal lymphocytes (atypical lymphocytes) is observed. Anti EBV antibodies may be demonstrated after one week. Polymerase Chain Reaction (PCR) may be used to detect the DNA of the EB virus. Complications: Blood-Hemolytic anemia (excessive destruction of red blood cells), thrombocytopenia (decrease in platelets) and neutropenia (decrease in number of neutrophils) can occur. Spleen may get ruptured rarely and is usually precipitated by trauma. Nervous system: Meningitis, encephalitis and transient damage to nerves are reported. Rare complications include myocarditis (inflammation of muscles of heart), pericarditis (inflammation of pericardium-a membrane covering the heart) and pneumonia. Some parents suffer from chronic active EBV infection lasting six months or more.
Page last reviewed on 24th January 2010
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