Epstein-Barr is the virus behind infectious mononucleosis, or mono. It is a common virus, transmitted during close physical contact. Most adults are infected at some point during their life, although most of them will only have mild symptoms. The incubation period of the virus is about one to two months.
General Symptoms
Among the symptoms of the Epstein-Barr virus are fever, sore throat and painfully swollen tonsils; and swollen, painful lymph nodes, particularly in the neck, which can be severe and mimic the neck stiffness of meningitis. The swelling of the neck and throat predisposes the patient to dehydration and, occasionally, airway obstruction. Patients can exhibit non-specific rashes, particularly if the patient receives penicillin, as the symptoms can mimic those of strep throat.
Gastrointestinal Symptoms
The most common gastrointestinal symptoms are enlargement of the liver and spleen. In particular, the spleen becomes tender and fragile, which can lead to rupture and massive internal bleeding if the organ suffers direct trauma. Inflammation of the liver can lead to an increase in the presence of liver enzymes in the blood, which can be detected by blood tests and can help establishing the diagnosis. Patients can also have nausea and vomiting, which can further worsen their hydration status.
Hematologic Symptoms
Patients with mononucleosis exhibit an increase in atypical lymphocytes, cells which the body uses to fight viral infections. Other blood findings include anemia and thrombocytopenia (a decrease in the platelet count). There is an association between infection with the Epstein-Barr virus and the development of certain cancers, for example Burkitt's lymphoma, a cancer of the lymphatic system.
Central Nervous System Symptoms
The Epstein-Barr virus can cause meningitis (swelling of the tissues surrounding the brain); encephalitis (inflammation of the brain itself); and transiently affect the cranial nerves, which control the muscles of the face and neck. Rarely, the infection can cause Guillan-Barré syndrome, a condition of progressive weakness that can lead to significant disability and respiratory failure.
