For individual infections please see the specific viral infections mentioned
- A clinical syndrome usually due to EBV but may also be seen due to several infectious agents which should be considered in the differential
- Commonly presents in late teens and early 20s
- Primary infection often occurs in adolescence
or later, from asymptomatic excreters
- Saliva is the main means of spread - droplet infection or environmental contamination in childhood, or by kissing among adolescents and young adults.
Causes of Infectious Mononucleosis type picture
- Epstein Barr Virus infection a gamma herpes virus
- Cytomegalovirus infection, Human Herpes Virus 6 or 7 infection
- HIV-1 infection, Toxoplasmosis
- Pharyngitis, cervical lymphadenopathy, fever
- Fatigue, Splenomegaly, Ampicillin rash (suggests EBV)
- Persisting fever and fatigue. Splenomegaly.
- Severe laryngeal oedema and post-viral fatigue.
- Cranial nerve palsies, meningoencephalitis
- Haemolytic anaemia, glomerulonephritis
- Pericarditis, pneumonitis
- Haemorrhage from splenic rupture or thrombocytopenia
Rare Long term complications
- Hodgkin's lymphoma
- Burkitt's lymphoma
- Nasopharyngeal carcinoma
- Serological Screening for above
- Monospot test (heterophile antibody absorption test): may initially
be negative so should be repeated if clinical suspicion is high
- Atypical lymphocytes on blood film
- EBV IgM antibodies.
- ABC, Gargle with aspirin to help sore throat.
- Oral prednisolone may be required to relieve laryngeal oedema.
- Supportive care. Avoid contact sports with splenomegaly until resolved.