Mononucleosis - Symptoms, Causes, Diagnosis, Treatment, and Complications

What Is Mononucleosis?

Mononucleosis, otherwise called infectious mononucleosis, mono, glandular fever, or the kissing disease, is a viral infection caused by the Epstein-Barr Virus (EBV). It commonly affects teenagers but can affect people of any age. It is called kissing disease because the virus is present in the saliva, which gets transmitted through kissing. Apart from kissing, you can also get infected if you are exposed to the virus through an infected person coughing or sneezing near you and sharing a glass or utensils with an infected individual.

Infants and young children get infected when adults kiss them, but they usually show mild symptoms and the infection goes undiagnosed. This infection causes severe signs and symptoms in young adults and teenagers. As it is a viral infection, rest and fluids will help you recover fast. Spleen enlargement is the most common complication of mono. Anyone who gets infected with EBV once is mostly immune to it for the rest of life.

What Are the Symptoms of Mononucleosis?

The most common symptoms of mono are:

• Extreme fatigue.

• High fever.

• Headache.

• Muscle weakness.

• Body pain.

• Enlarged spleen.

• Sore throat.

• Glands in the neck and underarm are swollen.

• Skin rash.

The severity of these symptoms varies depending on the age of the patient. For example:

1. Teenagers and young adults (15 to 24 years old) - This age group exhibits the most severe symptoms, which lasts for almost 2 to 4 weeks or longer. The symptoms are believed to be severe as more saliva is exchanged during kissing.

2. Infants and young children (under 14 years) - The symptoms are mild and not classic of a mono. They are often misdiagnosed as a common cold or the flu. They get infected from their parents, but as the amount of virus spread is less, the symptoms are less severe.

3. Older adults (above 40 years) - Older adults do not exhibit the classic signs of mono like sore throat and enlarged glands. They usually experience fever, muscle pains, and liver problems.

What Causes Mononucleosis?

In the majority of cases, mononucleosis is caused by Epstein-Barr Virus (EBV). EBV is a member of the herpes virus family and one of the most common viruses that cause infections in humans worldwide. Once a person gets infected with this virus, it stays inactive in the body lifelong, which can get reactivated in very rare cases. This virus is also linked to some types of cancer and autoimmune diseases. EBV can spread by:

• Coming in direct contact with an infected person’s saliva.

• Direct contact with an infected person’s bodily fluids.

• Sexual contact.

• Organ transplantation.

• Sharing food or drinks.

• Breastfeeding.

After you are infected, it takes around 4 to 8 weeks for the symptoms to develop. The other viruses that can result in mono are cytomegalovirus (CMV), toxoplasmosis, HIV (human immunodeficiency virus), rubella, hepatitis A, B, or C, and adenovirus.

What Are the Risk Factors for Mononucleosis?

The factors that increase the chances of a person getting infected with mononucleosis are:

• Teenagers and young adults between 13 and 25 years of age.

• Students.

• Medical professionals.

• Immunocompromised patients.

• Individuals who recently had blood transfusions or organ transplantation.

• Unprotected sexual intercourse.

How Is Mononucleosis Diagnosed?

The doctor will suspect mononucleosis based on your signs and symptoms. The doctor will then perform a physical examination, where he or she will look for swollen lymph nodes and tonsils, spleen, and liver. As serious infections such as hepatitis A also results in similar symptoms, the doctor might suggest you get the following tests done:

• Complete blood count (CBC) - The levels of different blood components will give the doctor an idea about how serious the illness is. A high lymphocyte (a type of white blood cell) count often is a sign of an infection. This is high because the body produces white blood cells to defend itself from the infection.

• The monospot test - Otherwise called heterophile test, and is the most common test used to diagnose mononucleosis, as it can be done easily and the result takes about an hour to come. The test looks for antibodies, which are produced in response to a virus or other foreign body. This test does not look specifically for antibodies against EBV but determines the levels of a group of antibodies (heterophile antibodies) in the body that also increases because of EBV. The body has detectable amounts of these antibodies after 2 to 4 weeks since the symptoms appear.

• EBV antibody test - If the monospot test is negative, then this test is done. This test looks antibodies specific to EBV. This blood test can detect mononucleosis in the first week after the symptoms appear.

How Is Mononucleosis Treated?

Most viral infections, including mononucleosis, do not have any specific treatment available. As it is caused by viruses, antibiotics do not work. Treatment can only help relieve symptoms until the body fights the infection off. The things you can do are rest, eat healthily, and drink enough water. If needed and in some cases, your doctor might prescribe the following medicines:

• Antibiotics - In some cases, strep throat, sinusitis, or tonsillitis can also develop as secondary infections. As these infections are caused by bacteria, antibiotics are given.

• Painkillers (Paracetamol, Aspirin, or Naproxin) - To relieve body pain and muscle aches.

What Are the Natural and Home Remedies for Mononucleosis?

The following home remedies can help relieve signs and symptoms of mononucleosis:

• To prevent dehydration, drink a lot of water, herbal teas, and fruit juices.

• Avoid giving Aspirin for kids under 3 years of age, as it can result in Reye's syndrome, which is a life-threatening and rare condition.

• Do salt water gargle by mixing half a teaspoon salt in a cup of warm water.

• Eat foods rich in antioxidants such as apples, green leafy vegetables, and salmon.

What Are the Complications of Mononucleosis?

The common complications include:

• Spleen enlargement.

• Inflammation of the liver (hepatitis).

• Jaundice.

Some of the rare complications are:

• Anemia (reduced red blood cells in the blood).

• Thrombocytopenia (low platelet count).

• Myocarditis (heart muscle inflammation).

• Tonsilitis (swollen tonsils).

• Meningitis and encephalitis (inflammation of the brain and surrounding membranes).

For more information on infectious mononucleosis, consult a doctor online now.