Mononucleosis

Description

Infectious mononucleosis (mono) is often called the kissing disease. The virus that causes mono (Epstein-Barr virus) is transmitted through saliva. You can get it through kissing, but you can also be exposed by sharing a drinking glass or eating utensils with someone who has mono. However, mono is not as contagious as some infections, like the common cold.

You are more likely to get mononucleosis with all the signs and symptoms if you are a teenager or a young adult. Young children usually have few symptoms, and the infection often is not diagnosed.

If you have mononucleosis, it is important to be careful of certain complications such as an enlarged spleen. Rest and plenty of liquids, are key to recovery.

Symptoms

The signs and symptoms of mononucleosis may include:

  • Fatigue
  • Sore throat, perhaps misdiagnosed as strep throat, that does not improve after treatment with antibiotics
  • Fever
  • Swollen lymph nodes in neck and armpits
  • Inflammation of the tonsils
  • Headache
  • Skin rash
  • Soft, swollen spleen

The virus has an incubation period of about four to six weeks, although in young children this period can be shorter. The incubation period refers to how long before your symptoms appear after exposure to the virus. The signs and symptoms, such as fever and sore throat usually lessen within a couple of weeks. But the fatigue, swollen lymph nodes and a swollen spleen may last for a couple more weeks.

When to see your doctor

If you've been experiencing the above symptoms, you may have mononucleosis.

If your symptoms do not improve on their own in a week or two, see your doctor.

Causes

The most common cause of mononucleosis is the Epstein-Barr virus, but other viruses can also cause similar symptoms. This virus is spread through saliva, and can be spread by kissing or sharing food or drinks.

Although the symptoms of mononucleosis are uncomfortable, the infection goes away on its own without long-term effects. The majority of adults have been exposed to the Epstein-Barr virus and have developed antibodies. This means that they are immune and do not get mono.

Complications

The complications of mono can sometimes be severe.

Enlargement of the spleen

Mononucleosis can cause enlargement of the spleen. In extreme cases, the spleen may rupture, causing sharp, sudden pain in the left side of the upper part of your abdomen. If pain occurs, seek medical attention immediately, you may need surgery.

Liver problems

Problems with your liver can also occur:

  • Hepatitis. You may be suffering from a mild inflammation of the liver (hepatitis).
  • Jaundice. The yellowing of the skin and the whites of the eyes (jaundice) also occurs from time to time.

Less common complications

Infectious Mononucleosis can also be the result of less common complications, including:

  • Anemia — a decrease in red blood cells and hemoglobin, an iron-rich protein in red blood cells
  • Thrombocytopenia — a low count of platelets, which are blood cells involved in clotting
  • Heart problems — an inflammation of the heart muscle (myocarditis)
  • Complications that affect the nervous system — meningitis, encephalitis, and Guillain-Barré syndrome
  • Inflammation of the tonsils — which can block breathing

The Epstein-Barr virus can cause more severe disease in people who have weakened immune systems. People with weakened immune systems may include people with HIV/AIDS or people who are taking medicines to suppress your immunity after an organ transplant.

Prevention

Infectious Mononucleosis is spread through the saliva. If you are 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 the fever has been improved and even more, if possible. And remember to wash your hands regularly to prevent the spread of the virus.

The Epstein-Barr virus may persist in the saliva for months after the infection. There is No vaccine to prevent mononucleosis.

Mononucleosis

Diagnosis

Physical examination

Your doctor may suspect mononucleosis based on signs and symptoms, how long it lasted, and a physical examination. He or she will look for signs such as swelling of the lymph nodes, tonsils, liver, or spleen, and consider how these signs relate to the symptoms you describe.

Blood tests

  • The antibody tests. If there is a need for additional confirmation, a monospot test may do blood tests to detect antibodies against the Epstein-Barr virus. This test gives results within a day. But it can't detect the infection during the first week of the disease. A different antibody test is required most of the time, but can detect the disease, even within the first week of symptoms.
  • White blood cell count. Your doctor may use other blood tests to look for a high number of white blood cells (lymphocytes) or abnormal appearance of the lymphocytes. These blood tests do not confirm the mono, but you can suggest it as a possibility.

Treatment

There is No specific treatment available for the treatment of infectious mononucleosis. Antibiotics do not work against viral infections such as mononucleosis. The treatment consists mainly in taking care of yourself, such as getting enough rest, eating a healthy diet and drink plenty of fluids. You can take over-the-counter pain relievers to treat fever or sore throat.

Drugs

  • The treatment of secondary infections and other complications.Streptococcal (strep) infection sometimes goes hand in hand with the sore throat of mononucleosis. You may also develop a sinus infection or an infection of the tonsils (tonsillitis). If so, you may need treatment with antibiotics for accompanying bacterial infections. Severe airway narrowing may be treated with corticosteroids.
  • The risk of skin rash with some medications. Amoxicillin and other antibiotics, including the facts of penicillin, it is not recommended for people with mononucleosis. In fact, some people with mononucleosis that taking one of these medications may develop a rash. The rash does not necessarily mean that they are allergic to antibiotics, however. If necessary, other antibiotics that are less likely to cause a rash are available for the treatment of infections that may go along with mononucleosis.

The treatment of secondary infections and other complications. Streptococcal (strep) infection sometimes goes hand in hand with the sore throat of mononucleosis. You may also develop a sinus infection or an infection of the tonsils (tonsillitis). If so, you may need treatment with antibiotics for accompanying bacterial infections.

Severe airway narrowing may be treated with corticosteroids.

Self-care

In addition to getting enough rest, these steps may help to alleviate the symptoms of mono:

  • Drink plenty of water and fruit juices. Fluids help relieve the fever and the sore throat and prevent dehydration.
  • Take over the counter medications to relieve the pain.The use of pain relievers such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others), as needed. These drugs do not have antiviral properties. It takes only to relieve pain or fever. Use caution when giving aspirin to children or teenagers. Even though aspirin is approved for use in children older than 3 years of age, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked with Reye's syndrome, a rare but potentially fatal in these children.
  • Gargle with salt water. Do this several times a day to relieve a sore throat. Mix 1/4 teaspoon (1.5 grams) of salt in 8 ounces (237 milliliters) of warm water.

Take over the counter medications to relieve the pain. The use of pain relievers such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others), as needed. These drugs do not have antiviral properties. It takes only to relieve pain or fever.

Use caution when giving aspirin to children or teenagers. Even though aspirin is approved for use in children older than 3 years of age, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked with Reye's syndrome, a rare but potentially fatal in these children.

Expect to return to sports and other activities

Most of the signs and symptoms of mononucleosis ease within a couple of weeks, but it can be two to three months before you feel completely normal. The more rest you get, the earlier it is to be retrieved. Return to your usual schedule too soon can increase the risk of a relapse.

To help avoid the risk of rupture of the spleen, your doctor may suggest that you wait about a month before returning to strenuous activities, lifting weights, roughhousing, or contact sports. Rupture of the spleen results in severe bleeding and is a medical emergency.

Ask your doctor about when it is safe for you to resume your normal level of activity. Your doctor may recommend a gradual exercise program to help you rebuild your strength as you recover.

Coping and support

Mononucleosis can last for weeks, keeping in your home while you recover. Be patient with your body fights the infection.

For young people, have mononucleosis means some type of loss of the classroom activities, and practices to the parties. Without a doubt, you will have to take it easy for a while. Students need to make their schools know that they are recovering from infectious mononucleosis and may need special considerations to continue with their work.

If you have mono, you do not necessarily have to be quarantined. Many people are already immune to the virus of Epstein-Barr virus, due to the exposure as children. But the plan is to stay in the house from school and other activities until they feel better.

Seek the help of friends and family while you recover from mononucleosis. College students should also contact the campus student health center staff care or treatment, if necessary.

Preparing for your appointment

If you suspect that you have mononucleosis, see your family doctor. Here's some information to help you prepare for your appointment and know what to expect from your doctor.

What you can do

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, pointing out the main tensions, recent changes in life, your daily routine, including sleep habits — or exposure to anyone with mononucleosis.
  • Make a list of all the medicines, vitamins, and supplements you are taking.
  • Write questions to ask their doctor.

Prepare a list of questions will help you make the most of your time with your doctor. For mononucleosis, some basic questions to ask your doctor include:

  • What are the most probable causes of my symptoms or condition?
  • Other that the most likely cause, what are other possible causes for my symptoms or condition?
  • What tests do I need?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • What do I need to go to work or school? How long should I stay home?
  • When I can go back to strenuous activities and contact sports?
  • There are medications should I avoid?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

Do not hesitate to ask any other questions.

What to expect from your doctor

Your doctor may ask you a series of questions, including:

  • When do symptoms develop?
  • Has been exposed to someone with infectious mononucleosis?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Mononucleosis