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 Infectious
mononucleosis (or "mono" for short) is an infection that is transmitted
through the saliva. Because of this, it has been referred to as
"the kissing disease." Mono usually resolves spontaneously after
one to two weeks without treatment.
The
cause of infectious mononucleosis is a virus called the Epstein-Barr
virus, named after its discoverers. The Epstein-Barr virus is
a member of the Herpes virus family, a group that also causes cold
sores, genital herpes, chicken pox and shingles. Mono usually affects
people between the ages of 10 to 35, though people outside
this range can get the disease.
After
being exposed to someones infected saliva, it takes about two weeks
before symptoms begin. These symptoms usually include fever, sore
throat, swollen lymph nodes (or enlarged glands, commonly noticed
in the neck) and just plain feeling lousy (e.g. muscle aches, loss
of appetite, nausea, headache, feeling tired all day long). Sometimes,
other symptoms are present, including a rash or abdominal pain due
to an enlarged spleen or liver inflammation.
The
diagnosis of mono is often delayed because the condition resembles
Strep throat, a bacterial infection that is a more common cause
of sore throat, fever, swollen lymph nodes and "feeling lousy."
Sometimes antibiotics are prescribed mistakenly by the physician,
who can easily be fooled into thinking Strep throat is present.
Interestingly,
about 90% of people develop a rash when given some form of penicillin
(such as ampicillin
or amoxicillin)
in the setting of infectious mononucleosis. You should always let
your doctor know if you develop a rash when given an antibiotic.
This could represent an allergy to the medication or a misdiagnosis.
When
mono is suspected, a simple blood test can usually confirm the diagnosis.
Unfortunately, there is no treatment for the disease. No antibiotics
are available to treat mono, as is the case with many viral infections.
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Infectious
Mononucleosis
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Often,
aspirin helps with the pain and inflammation symptoms and salt gargles
can be used for the sore throat. There are some important things
to know about the disease even though no cure is known.
One
of the problems in mono is that it can cause an enlarged spleen,
which is an organ underneath the rib cage on the left side just
below the lung and diaphragm.
The
spleen is important in controlling infection and in storing certain
cells that circulate in the blood. When enlarged, the spleen may
no longer be protected by the rib cage and is vulnerable to injury.
Thus, people with mono may be asked to avoid contact sports for
up to one month to avoid rupture of the spleen, which can be fatal.
Rarely,
other complications of mono can occur. These include hepatitis (an
inflammation of the liver which can cause jaundice, or yellowing
of the eyes and skin), anemia (low blood count) and myocarditis
(an infection of the heart which can be quite serious).
Even
more unusual are the complications of meningitis (an infection of
the protective lining which surrounds the brain), encephalitis (an
infection of the brain itself), and paralysis and/or pain due to
nerve inflammation. Fortunately, these complications are uncommon.
Normally, the disease resolves on its own in one to two weeks.
Many
people who have had mono describe lingering symptoms of fatigue,
weakness and "feeling lousy" for up to three months after the initial
infection. It is not known why this occurs.
There
are some in the medical community who believe the Epstein-Barr virus
can sometimes cause what is known as chronic fatigue syndrome, a
debilitating disease that can last for years. There is also some
evidence that links the Epstein-Barr virus to certain forms of blood
cancer, such as lymphoma.
Infectious
mononucleosis is a relatively common disease that usually affects
young adults. While there is no specific treatment for the Epstein-Barr
virus that causes mono, there are some complications of the disease
that are important to recognize.
Usually,
that innocent kiss is nothing more, but occasionally the Epstein-Barr
virus reminds us of just much trouble one kiss can lead to.
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