Infectious Mononucleosis
Infectious mononucleosis (mono) is a common acute infectious disease usually found in adolescents and young adults. It is caused by the Epstein-Barr virus (EBV).
Classic symptoms of infectious mononucleosis are fever, sore throat, and swollen lymph glands. Sometimes, liver involvement may develop, causing nausea, vomiting, decreased appetite, abdominal pain, and/or yellowing of the skin or whites of the eyes (jaundice). A swollen spleen may cause abdominal pain and places the person at risk for splenic rupture, which requires emergency treatment. Heart problems or involvement of the central nervous system occur(s) only rarely, and infectious mononucleosis is almost never fatal. There are no known associations between active EBV infection and problems during pregnancy, such as miscarriages or birth defects. Although the symptoms of infectious mononucleosis usually resolve in 1-2 months and rarely last more than four months, EBV remains latent in a few cells in the throat, blood, and immune system for the rest of the person’s life. This dormancy is characteristic of all herpes viruses. Periodically, the virus can reactivate and is commonly found in the saliva of infected persons. This reactivation usually occurs without symptoms of illness.
DIAGNOSIS
Diagnosis is sometimes confirmed by blood test(s). Typical test results include an elevated white blood cell (WBC) count, an increased percentage of certain typical WBC’s, and a positive “mono spot” (antibody) test. The mono spot test has about a 10-15% false negative rate, but these occur primarily in children under ten. Your provider may wish to repeat the test in a week or so. When the test is repeatedly negative, a person with a mononucleosis-like illness may have cytomegalovirus, HIV, Hepatitis B, toxoplasmosis, or Human Herpesvirus 6 or 7 infection.
TREATMENT
There is no vaccine available. Antiviral medication has never been shown to be effective. Treatment is symptomatic and supportive, but medical supervision may be necessary.
Instructions:
- Obtain 10-12 hours of sleep a day.
- No contact sports, weightlifting, or jumping for about 3 weeks. Avoid exercise until your energy returns to normal.
- Do not drink alcohol.
- Do not take Tylenol (acetaminophen).
- Increase your intake of fluids; avoid caffeine.
- Avoid social activities; limit activities to sleeping, eating, and studying and, if able, classes. Rest as necessary.
- Remain at home if fever develops.
- Eat a well-balanced diet.
RECOVERY
The acute phase generally lasts 1-2 weeks; at the end of that time, normal stamina is regained to about 90%. Full recovery may take 1-2 months, possibly longer.
If diagnosed with infectious mononucleosis, you should not take amoxicillin. It may cause a severe rash which can persist for months.
Contact the Dial-A-Nurse at 333-2700, or seek medical attention if severe abdominal pain, excessive vomiting, decreased mental status and/or confusion, dizziness upon standing or dark urine develop.
CONTAGION
Mono is passed directly from person to person by contact with saliva or the mouth. Do not share eating or drinking utensils or toothbrush. Practice good handwashing before food preparation, eating and after bathroom use.
References
Aronson, M. D., & Auwaerter, P. G. (2010). Infectious mononucleosis in adults and adolescents. Retrieved from http://www.uptodate.com/online/content/topic.do?topicKey=viral_in/27361&selectedTitle=1%7E150&source=search_resultNational Center for Infectious Diseases. (2006). Epstein-Barr Virus and Infectious Mononucleosis. Retrieved from http://www.cdc.gov/ncidod/diseases/ebv.htm
Up To Date website, Patients Index, http://www.uptodate.com/patients/index.html