Imagine this. You are a sixteen year old at prom. You muster up the courage to finally have your first kiss and it goes well. You go on with your life as usual. Six weeks later, you randomly have difficulty getting up when your alarm rings for school. You feel more exhausted then you usually feel after a night of partying. You go to the bathroom and look at yourself in the mirror. Hmmmm..something seems off. Could it be that one side of your face seems a little swollen? You show your mom. She is a nurse and asks if you have been smooching anyone. WHAT? How does she know? After a quick visit to your family doctor, It's confimed. You have Mono! How embarassing.
Well, let's not dwell on the awkwardness of it but let's learn some basic facts about it so you know to prevent and treat it if it does turn up at your local high school.
Infectious mononucleosis is a disease caused by a virus called Ebstein-Barr virus. It spreads through close oral contact and has a long incubation period, roughly one to two months.
Signs and Symptoms:
Clinical signs and symptoms are listed in the figure above and include fever, fatigue, sore throat, and lymphadenopathy (hence the teenager's swollen face). Hepatosplenomegaly, which is enlargement of the liver and spleen, can cause further issues such as lack of appetite and vomiting.
An interesting phenomenon which happens to some patients with this disease is that they may develop a rash after amoxicillin administration.
Diagnosis:
Diagnosis is confirmed with a Monospot test, which tests for heterophile (induced by external antigen) antibodies directed toward mammal red blood cells. This test may be false positive in some auto-immune diseases and cancers.
We can also take peripheral blood smears and look at them under the microscope. We should be able to see the following:
These are atypical lymphocytes, characterized by large amounts of cytoplasm and an abnormally shaped nucleus. This test is also not very specific.
Some patients may present with a transient hepatitis as well.
Complications:
Albeit rare, Infectious mononucleosis can cause more serious health issues such as splenic rupture, upper airway obstruction due to pharyngeal inflammation, thrombocytopenia, and hemolytic anemia.
Treatment and Prevention:
To date, there is no effective treatment for infectious mononucleosis. We can help alleviate symptoms by recommending rest, drinking fluids, over the counter analgesics etc. One important thing to consider is limiting physical activity such as contact sports for at least a month to prevent splenic rupture.
We can prevent it by avoiding sharing personal items such as water bottles, food, toothbrushes, and you guessed it, kisses with people who have this condition.
Hopefully this article was able to shed some light on the importance of practicing good hygiene.
Sources:
Assessed and Endorsed by the MedReport Medical Review Board