The virus typically lives dormantly in B lymphocytes. [43] The need for rest and return to usual activities after the acute phase of the infection may reasonably be based on the person's general energy levels. Yet, 20% of people may have antibodies against EA for years despite having no other sign of infection. [13] When older adults do catch the disease, they less often have characteristic signs and symptoms such as the sore throat and lymphadenopathy. [21], People with infectious mononucleosis are sometimes misdiagnosed with a streptococcal pharyngitis (because of the symptoms of fever, pharyngitis and adenopathy) and are given antibiotics such as ampicillin or amoxicillin as treatment.

[2][59][60], The characteristic symptomatology of infectious mononucleosis does not appear to have been reported until the late nineteenth century. Occasionally the disease may persist and result in a chronic infection. [49][50] Although antivirals are not recommended for people with simple infectious mononucleosis, they may be useful (in conjunction with steroids) in the management of severe EBV manifestations, such as EBV meningitis, peripheral neuritis, hepatitis, or hematologic complications. Moscow, A. Lang, 1887. [13][18] Occasional cases of erythema nodosum and erythema multiforme have been reported. [3] It is primarily spread through saliva but can rarely be spread through semen or blood. But once infected, the person carries the virus for the rest of their life. [5] The disease occurs equally at all times of the year. "Mononucleosis and athletic participation: an evidence-based subject review", "Steroids for symptom control in infectious mononucleosis", "Antiviral agents for infectious mononucleosis (glandular fever)", "Five Things Physicians and Patients Should Question", "Symptomatic atrial fibrillation with infectious mononucleosis", "An updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis", "Compartmentalization and Transmission of Multiple Epstein-Barr Virus Strains in Asymptomatic Carriers", "On the dynamics of acute EBV infection and the pathogenesis of infectious mononucleosis", "Antiquity of Epstein-Barr virus, Sjögren's syndrome, and Hodgkin's disease--historical concordance and discordance", "Historical Timeline | Yale School of Public Health", "Relation of Burkitt's tumor-associated herpes-ytpe virus to infectious mononucleosis", "Alfred S. Evans, 78, Expert On Origins of Mononucleosis", Extranodal NK/T-cell lymphoma, nasal type, Progressive multifocal leukoencephalopathy,, Articles with unsourced statements from March 2017, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License.

Contrary to common belief, the Epstein–Barr virus is not highly contagious.

It is one of the most commonly found viruses throughout the world. [8] In the developing world, people are more often infected in early childhood when there are fewer symptoms. Mononucleosis is sometimes called “the kissing disease,” but kissing isn’t the only way you can get it.

[70], "Mononucleosis" redirects here. [6], While usually caused by Epstein–Barr virus, also known as human herpesvirus 4, which is a member of the herpesvirus family,[3] a few other viruses may also cause the disease. [61] In 1885, the renowned Russian pediatrician Nil Filatov reported an infectious process he called "idiopathic adenitis" exhibiting symptoms that correspond to infectious mononucleosis, and in 1889 a German balneologist and pediatrician, Emil Pfeiffer, independently reported similar cases (some of lesser severity) that tended to cluster in families, for which he coined the term Drüsenfieber ("glandular fever").[62][63][64].

[13][21] Instead, they may primarily experience prolonged fever, fatigue, malaise and body pains. Glandular fever, Pfeiffer's disease, Filatov's disease.

[9], There is no vaccine for EBV, but infection can be prevented by not sharing personal items or saliva with an infected person. [32] The length of time that an individual remains contagious is unclear, but the chances of passing the illness to someone else may be the highest during the first six weeks following infection. [26] (See Prognosis.

[47][48], There is little evidence to support the use of antivirals such as aciclovir and valacyclovir although they may reduce initial viral shedding. [25], Infectious mononucleosis mainly affects younger adults.

13th ed.

[54] However, because spleen size varies greatly, ultrasonography is not a valid technique for assessing spleen enlargement and should not be used in typical circumstances or to make routine decisions about fitness for playing sports. Person's age, with highest risk at 10 to 30 years. [13] Almost all people given amoxicillin or ampicillin eventually develop a generalized, itchy maculopapular rash, which however does not imply that the person will have adverse reactions to penicillins again in the future. [3][8] The monospot test is not recommended for general use due to poor accuracy. [2][7] Those who are infected can spread the disease weeks before symptoms develop. [13], About 90% of cases of infectious mononucleosis are caused by the Epstein–Barr virus, a member of the Herpesviridae family of DNA viruses. The signs and symptoms of infectious mononucleosis vary with age. [2] Mono is primarily diagnosed based on the symptoms and can be confirmed with blood tests for specific antibodies. [34], When the infection is acute (recent onset, instead of chronic), heterophile antibodies are produced. [citation needed], Acute HIV infection can mimic signs similar to those of infectious mononucleosis, and tests should be performed for pregnant women for the same reason as toxoplasmosis. [2] Mono generally improves without any specific treatment. Mononuclear leukocytosis in reaction to acute infection (infectious mononucleosis). Infectious mononucleosis (IM, mono), also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV). This test is specific but not particularly sensitive (with a false-negative rate of as high as 25% in the first week, 5–10% in the second, and 5% in the third). [5] Nearly 95% of people have had an EBV infection by the time they are adults. [21], Cytomegalovirus, adenovirus and Toxoplasma gondii (toxoplasmosis) infections can cause symptoms similar to infectious mononucleosis, but a heterophile antibody test will test negative and differentiate those infections from infectious mononucleosis. The word mononucleosis has several senses. Swollen lymph nodes in your neck and armpits 5. Skin rash 8.

[30] A person becomes infected with this virus by direct contact with infected body fluids.

[2][3] Most people are infected by the virus as children, when the disease produces few or no symptoms. Learn from the experts at WebMD how to spot the signs of mono and get the right treatment. Diagnostic modalities for infectious mononucleosis include: The presence of an enlarged spleen, and swollen posterior cervical, axillary, and inguinal lymph nodes are the most useful to suspect a diagnosis of infectious mononucleosis. North Melbourne: Therapeutic Guidelines; 2006.

[2] Most people recover in two to four weeks; however, feeling tired may last for months.

Antibiotic Expert Group. [citation needed], Other conditions from which to distinguish infectious mononucleosis include leukemia, tonsillitis, diphtheria, common cold and influenza (flu). When found, symptoms tend to be similar to those of common throat infections (mild pharyngitis, with or without tonsillitis). [2][35], Mononucleosis is sometimes accompanied by secondary cold agglutinin disease, an autoimmune disease in which abnormal circulating antibodies directed against red blood cells can lead to a form of autoimmune hemolytic anemia. For those with weak immune systems, cytomegalovirus can cause more serious illnesses such as pneumonia and inflammations of the retina, esophagus, liver, large intestine, and brain. ), The exact length of time between infection and symptoms is unclear. E. Pfeiffer: Drüsenfieber. [54], Serious complications are uncommon, occurring in less than 5% of cases:[55][56], Once the acute symptoms of an initial infection disappear, they often do not return. [2] In young adults, the disease often results in fever, sore throat, enlarged lymph nodes in the neck, and tiredness. [13], In adolescence and young adulthood, the disease presents with a characteristic triad:[14], Another major symptom is feeling tired. When positive, they feature similar specificity to the heterophile antibody test. Swollen tonsils 6. The insensitivity of the physical examination in detecting an enlarged spleen means it should not be used as evidence against infectious mononucleosis. Serologic tests detect antibodies directed against the Epstein–Barr virus. [21][44], Paracetamol (acetaminophen) and NSAIDs, such as ibuprofen, may be used to reduce fever and pain. Infectious mononucleosis (IM, mono), also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV).

Antibody to EBNA slowly appears 2 to 4 months after onset of symptoms and persists for the rest of a person’s life. [31] Once a person becomes infected with cytomegalovirus, the virus stays in his/her body fluids throughout the person's lifetime. Baltimore, 1920;31:410-417. [2] Symptoms may be reduced by drinking enough fluids, getting sufficient rest, and taking pain medications such as paracetamol (acetaminophen) and ibuprofen.

Cytomegalovirus is most commonly transmitted through kissing and sexual intercourse.

[21], The heterophile antibody test, or monospot test, works by agglutination of red blood cells from guinea pig, sheep and horse. [13] They are more likely to have liver enlargement and jaundice. The cold agglutinin detected is of anti-i specificity.[36][37]. [28] About 95% of the population has been exposed to this virus by the age of 40, but only 15–20% of teenagers and about 40% of exposed adults actually become infected.[29]. [8] About 45 out of 100,000 people develop infectious mono each year in the United States. Fatigue 2. [14] Symptoms most often disappear after about 2–4 weeks. [21] Jaundice occurs only occasionally. This virus is found in body fluids including saliva, urine, blood, and tears. Therapeutic guidelines: Antibiotic.

Н. Филатов: Лекции об острых инфекционных болезнях у детей [N. Filatov: Lektsii ob ostrikh infeksionnîkh boleznyakh u dietei].

Epstein-Barr virus-associated lymphoproliferative diseases, Postural orthostatic tachycardia syndrome, "JAMA PATIENT PAGE. [41], Infectious mononucleosis is generally self-limiting, so only symptomatic or supportive treatments are used. Most people are infected by the virus as children, when the disease produces few or no symptoms. [2][4], Mono most commonly affects those between the ages of 15 to 24 years in the developed world. [8] Mononucleosis was first described in the 1920s and colloquially known as "the kissing disease".[11]. [25] When caused by EBV, infectious mononucleosis is classified as one of the Epstein-Barr virus-associated lymphoproliferative diseases. However, in pregnant women, differentiation of mononucleosis from toxoplasmosis is important, since it is associated with significant consequences for the fetus.

[62][66] A lab test for infectious mononucleosis was developed in 1931 by Yale School of Public Health Professor John Rodman Paul and Walls Willard Bunnell based on their discovery of heterophile antibodies in the sera of persons with the disease. A minority of cases of infectious mononucleosis is caused by human cytomegalovirus (CMV), another type of herpes virus.

[2] Spread may occur by objects such as drinking glasses or toothbrushes or through a cough or sneeze.

However, in susceptible hosts under the appropriate environmental stressors, the virus can reactivate and cause vague physical symptoms (or may be subclinical), and during this phase the virus can spread to others. A review of the literature made an estimate of 33–49 days. However, ampicillin and amoxicillin are not recommended during acute Epstein–Barr virus infection as a diffuse rash may develop. [45][46] Intravenous corticosteroids, usually hydrocortisone or dexamethasone, are not recommended for routine use but may be useful if there is a risk of airway obstruction, a very low platelet count, or hemolytic anemia.

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