Infectious mononucleosis: The "kissing disease"

Abstract

Infectious mononucleosis is a clinical syndrome characterized by fever, pharyngitis, lymphadenopathy, and atypical lymphocytosis. It is caused by the Epstein-Barr virus and primarily affects adolescents and young adults. Primary infections acquired during childhood are usually asymptomatic. Transmission occurs by close contact with saliva of infected individuals. Final diagnosis can be made by a positive monospot test confirming the presence of heterophile antibodies, although the monospot test is unreliable during the first week of illness and in young children. Treatment consists of supportive care ensuring appropriate hydration, rest, and use of analgesic/antipyretic agents for symptom relief. Corticosteroids should be reserved for complicated cases with respiratory compromise, severe thrombocytopenia, and hemolytic anemia. There is no role for antivirals in the treatment of IM. Restricted physical activity with avoidance of all contact sports and weight-bearing activities should be enforced during the first three weeks after onset of symptoms to decrease the risk of spleen rupture. Gradual return to athletic activities should be individualized based on symptoms and clinical exam. The prognosis for IM is good, with low incidence of complications. Acute symptoms usually resolve in two to three weeks, but mild fatigue may persist longer. Copyright © 2000-2008 Jobson Medical Information LLC unless otherwise noted. All rights reserved.