Read more about this disease, some with Classification – Types – Signs and symptoms – Genetics – Pathophysiology – Diagnosis – Screening – Prevention – Treatment and management – Cures and much more, some including pictures and video when available.
EBV infectious mononucleosis (also known as Pfeiffer’s disease, colloquially as the kissing disease, or as mono in Northern America and more commonly known as glandular fever in other English-speaking countries) is an infectious, viral disease which most commonly occurs in adolescents and young adults. It is characterized by fever, sore throat and fatigue, along with several other possible signs and symptoms. It is primarily diagnosed by observation of symptoms, but suspicion can be confirmed by several diagnostic tests.
The syndrome was described as an infectious process by Emil Pfeiffer in 1889.[1][2]
Mononucleosis has a set of common symptoms that are usually presented in the individual with the disease. The classical symptoms are a sore throat, fever, fatigue, weight loss, malaise, pharyngeal inflammation and petechiae, and common signs include lymphadenopathy (enlarged lymph nodes), splenomegaly (enlarged spleen), hepatitis (refers to inflammatory cells in the liver) and hemolysis (the bursting of red blood cells). Older adults are less likely to have a sore throat or lymphadenopathy, but are instead more likely to present with hepatomegaly (enlargement of the liver) and jaundice. Rarer signs and symptoms include thrombocytopenia (lower levels of platelets, with or without pancytopenia (lower levels of white blood cells)), splenic rupture, splenic hemorrhage, upper airway obstruction, pericarditis and pneumonitis. Another rare manifestation of mononucleosis is erythema multiforme.[3][4]
Mononucleosis is sometimes accompanied by secondary cold agglutinin disease—an autoimmune disease in which abnormal circulating antibodies directed against red blood cells can lead to a form of autoimmune hemolytic anemia. The cold agglutinin detected is of anti-i specificity.[5] Patients with infectious mononucleosis are sometimes misdiagnosed with a streptococcal pharyngitis (because of the classical clinical triad of fever, pharyngitis and adenopathy) and are given antibiotics such as ampicillin or amoxicillin as treatment. Some studies indicate that approximately 80-90% of patients with acute Epstein Barr virus infection treated with such antibiotics develop a red, diffuse rash. [6]
Infectious mononucleosis occurs with infection by the Epstein-Barr virus.[7] (A similar condition can be caused by cytomegalovirus. Because of this, some sources say that infectious mononucleosis is “usually caused by the Epstein-Barr virus”[8]. Other sources reserve a different term, “cytomegalovirus mononucleosis”, for mononucleosis caused by cytomegalovirus.[9]. Some sources state that infectious mononucleosis can also be caused by toxoplasmosis or viral hepatitis.[10])
The infection is spread via saliva and has an incubation period of up to 8 weeks.
The virus replicates first within epithelial cells in the pharynx (which causes sore throat), and later primarily within B cells (which are invaded via their CD21). The host immune response involves cytotoxic (CD8-positive) T cells against infected B lymphocytes, resulting in enlarged atypical lymphocytes (Downey cells).[11][12]
When the infection is acute (recent onset, instead of chronic), heterophile antibodies are produced.[4]
[tubepress mode=’tag’, tagValue=’Infectious mononucleosis’]