Infectious mononucleosis (EB)
Alternative names:
mononucleosis - EB; Epstein-Barr viral syndrome, mono
Definition:
An acute viral infection
causing high temperature, sore
throat, and swollen lymph
glands, especially in the neck. It is typically caused
by the Epstein-Barr virus.
Causes, incidence, and risk factors:
Mononucleosis-like disease may be caused by the Cytomegalovirus
(CMV) as well as the classical mononucleosis of the Epstein-Barr
virus (EBV). Both viruses are members of the herpes virus
family. Mononucleosis caused by EBV is the most frequently
encountered type and is responsible for approximately 85%
of infectious mononucleosis cases. The infection is probably
transmitted by saliva. While peak incidence
occurs in 15- to 17-year-olds, the infection may occur in
any age, being most often diagnosed between ages 10 to 35
years.
Infectious mononucleosis may begin slowly with fatigue,
malaise, headache,
and sore throat. The
sore throat becomes progressively worse, often with enlarged
tonsils covered with a whitish-yellow fibrinous exudate.
The lymph nodes in the neck are frequently enlarged and painful.
A pink measles-like rash
may occur in approximately one out of five individuals with
mono. Four out of five patients with mononucleosis who are
given ampicillin or amoxicillin for their "throat infection"
will develop the rash but it is significantly darker and denser
than the rash in those not given medication. Symptoms of mononucleosis
gradually subside over a period of weeks to a month. The disease
is generally self limiting.
Risk factors other than age are not known. The incidence in
the United States is 2 out of 1,000 in adolescents and young
adults. It is significantly lower for the entire U.S. population.
Age of infection varies from country to country. For example,
in Africa most individuals have been infected by age 3 years,
an age at which there are very few symptoms. EBV infection
may be associated with some types of malignancy.
In Africa EBV is associated with Burkitt's
lymphoma, while in China and among the Eskimos, EBV may
be associated with cancers of the nose and throat (nasopharyngeal
carcinoma).
Updated Date: 02/09/00
Updated By:J. Gordon Lambert, MD, Associate Medical Director,
Utah Health Informatics and adam.com
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