Causative & risk factors
Mononucleosis is caused due to infection with the Epstein–Barr virus. It can be transmitted through contact with the saliva of an infected person via kissing, coughing, sneezing or sharing food and drink.
Clinical presentation
The incubation period of the Epstein–Barr virus is about 4 to 6 weeks. Infected children and young adults often remain asymptomatic, whereas older persons tend to develop symptoms which last for 4 to 8 weeks.
The patient complains of sore throat and fever, sometimes with night sweats. He is fatigued and may complain of headache and muscle weakness. The tonsils appear swollen and enlarged. The lymph glands in the neck and armpits are also swollen. On examination, the liver and spleen may be found to be enlarged.
A severe bout of mono can give rise to complications especially in immune-compromised individuals. These include rupture of the spleen, hepatitis, anemia, thrombocytopenia, myocarditis, meningitis, encephalitis or Guillain-Barre syndrome.
Investigations
The patient’s symptoms and a physical exam are adequate to make a diagnosis of mononucleosis. A blood test to detect antibodies against the Epstein-Barr virus may be advised. A complete blood count may be performed to help eliminate the possibility of other infections.
Treatment
Since this is a viral infection, antibiotics are not routinely prescribed, unless there is a secondary bacterial infection.
Rest, simple home-cooked food and adequate hydration form the mainstay of treatment.
Corticosteroids may be prescribed to ease throat symptoms. The prognosis is excellent. Most people make a complete recovery within 1 to 2 months.
