Mononucleosis

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Mononucleosis

Definition:

Mononucleosis is a viral infection causing fevers, sore throat, and swollen lymph glands, especially in the neck. It is typically caused by the Epstein-Barr virus (EBV), but can also be caused by other organisms such as cytomegalovirus (CMV). Both viruses are members of the herpesvirus family.

Alternative Names:
Infectious mononucleosis; Mono; Kissing disease; Epstein-Barr viral syndrome
Causes, incidence, and risk factors:

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Mononucleosis is often transmitted by saliva. While it is known as "the kissing disease," occurring most often in 15- to 17-year-olds, the infection may occur at any age.

Mono may begin slowly with fatigue, malaise, headache, and sore throat. The sore throat becomes progressively worse, often with enlarged tonsils covered with a whitish-yellow covering. The lymph nodes in the neck are frequently enlarged and painful.

A pink, measles-like rash can occur and is more likely if the patient is given ampicillin or amoxicillin for a throat infection. (Antibiotics should NOT be given without a positive strep test.) The symptoms of mono gradually subside on their own over a period of weeks to months.

Chronic EBV infection may be associated with some rarer types of cancer. In Africa, for example, EBV is associated with Burkitt's lymphoma. In organ transplant patients, it can cause post-transplant lymphoproliferative disease (PTLD), a type of lymphoma.

References:

Hoffman, R., ed. Hematology: Basic Principles and Practice. 4^th Ed. New York, NY: Churchill Livingstone, 2005.

Gershon, AA, Hotez, PJ, and Katz, SL, eds. Krugman?s Infectious Diseases of Children. 11^th ed. St. Louis, MO: Mosby; 2004.

Noble J, ed. Textbook of Primary Care Medicine. 3^rd Ed. St. Louis, MO: Mosby; 2001.