Epstein-Barr is the virus that causes infectious mononucleosis, which is often called the kissing disease.The virus can be spread through saliva which is why people can get it from kissing, but the virus also can be transmitted through droplets spread through coughing or by sharing utensils.
Occurrence
Infectious mononucleosis is seen most frequently in the young adult population, especially those 15 to 30 years of age, according to "Clinical Practice of Emergency Medicine." Early fall and spring are the two peak times for infection.
Symptoms
Patients who have the virus usually describe nonspecific symptoms, such generalized weakness, poor appetite and lack of energy. Within a couple of days, the patient may develop fever, sore throat and swollen glands in the neck area. The sore throat often is what causes patients to seek medical care.
Considerations
Mononucleosis can cause the spleen, an organ that acts as a blood reservoir for the body, to become enlarged. Enlargement of the spleen may not appear until the second or third week of the illness and may lead to rupture, causing sharp, sudden pain in the left upper area of the abdomen. A ruptured spleen is a medical emergency that could require surgery.
Patients may also develop anemia, meaning the body does not have enough healthy red blood cells, and the liver may be affected, causing yellowing of the skin and the whites of the eyes.
Treatment
The treatment for infectious mononucleosis is usually supportive care. Medications are prescribed to manage the fever and pain associated with the sore throat. In cases where the sore throat is a streptococcal infection, antibiotics may be prescribed. Due to the enlargement of the spleen and the potential for it to rupture, contact sports should be avoided for 6 to 8 weeks. Rest and plenty of fluids help fight off the infection and prevent dehydration.
Outcome
Most patients do well without any major treatments and do not require hospitalization. Patient typically are instructed to seek emergency treatment if abdominal pain develops or breathing or swallowing becomes difficult.
References
- "Clinical Practice of Emergency Medicine"; Lippincott Williams & Wilkins; 2010
