Infectious mononucleosis (CMV)

Causes and Risks:
The infection is caused by two viruses, the Epstein-Barr virus (EB) or cytomegalovirus ( CMV pneumonia ), both members of the herpes virus family. Infection with CMV occurs less commonly than Epstein-Barr. The infection is probably transmitted by saliva, sexual contact, respiratory droplets, and blood transfusions. Sore throat is less common in CMV infectious mononucleosis than in Epstein-Barr. While the peak incidence occurs in 15- to 17-year-old adolescents, the infection may occur at any age, usually between 10 and 35 years old. Abnormal lymphocytes (white blood cells) are seen in the peripheral blood and may persist for 2 to 8 weeks. Abnormalities of liver function are also characteristic. Risk factors other than age are not known. The incidence is 8 out of 100,000 people.

Prevention:
Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person. Since the infection is probably spread by saliva or through sexual contact, kissing or other transfer of oral secretions and sexual contact with an infected person should be avoided.

Symptoms:

Less frequently occurring symptoms include:



Signs and Tests:
A physical examination reveals an enlarged liver and (or) an enlarged spleen . The liver and spleen may be tender when they are gently pressed ( palpation ). There may be skin rash present.



Treatment:
Most patients recover within 4 to 6 weeks without medication. There is no specific treatment available; antiviral medications do not help. Rest is needed, sometimes for a month or longer to regain full activity levels. Relief of symptoms is provided with analgesics , and warm salt water gargles for sore throat .

Prognosis:
Fever usually reduces in 10 days, and swollen lymph glands and spleen return to normal in 4 weeks. Fatigue may linger for 2 to 3 months.

Complications:

  • secondary throat infection
  • rupture of spleen (rare)
  • neurologic complications (rare)



Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms indicate mononucleosis .

Go to the emergency room or call the local emergency number (such as 911) if sharp, sudden pain in left upper abdomen occurs. This could indicate a ruptured spleen, and require emergency surgery.


Mononucleosis is an infectious disease caused by the Epstein-Barr virus (EBV). A rash may appear early in the illness which is red (erythematous), flat (macular) to slightly raised, and does not itch. Individuals with mono who are given ampicillin or amoxicillin may develop a significant rash which is very noticeable.



Mononucleosis is an infectious disease caused by the Epstein-Barr virus (EBV). A rash may appear early in the illness which is red (erythematous), flat (macular) to slightly raised, and does not itch. People with mono who are given ampicillin or amoxicillin may develop a significant rash which is very noticeable.



This so-called "Downy cell" is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.



This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a "Downy cell". Downy cells may be classified as types I, II, or III; this is a type I Downy cell.







Mononucleosis is an infectious disease usually thought of as causing fatigue and swollen lymph nodes. However, mononucleosis has multiple other symptoms including various rashes. Interestingly, the antibiotic ampicillin significantly increases the rash.



This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.



Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.