Infectious mononucleosis – initial infection caused with Epstein-Barr virus (EBV)

Infectious mononucleosis or Filatov's diseasePfeiffer's disease, Glandular fever, subleukemic leukocytosis, benign leukemia, lymphomonocytic angina etc. – it is an initial infection caused with Epstein-Barr virus (EBV) which has the following symptoms:

• fever;
• intoxication;
• tonsillitis;
• enlarged spleen, liver and lymph nodes;
• atypical mononuclear leukocytes in peripheral blood.

EBV, like the other herpesviruses , persist in blood for the long period and may have chronicle or latent form with the periodic exacerbations.

EBV is widely spread all over the world and about 90-95% of adults are infected by the virus.

Sick people or virus hosts are the sources of infection.

Infection transmits by droplet, contact, alimentary, transfusion, sexual way, rarely – vertically and by organs' transplantation. One of the names of infectious mononucleosis - kissing disease – points to the most spread way of its transmission.

Symptoms and course of illness:

Infectious mononucleosis has several forms according to the kinds of manifestation:

ü according to the clinical signs: typical, atypical and subclinical;

ü according to severity: light, moderate severity and severe;

ü according to course: acute and chronicle

Typical form of infectious mononucleosis

Latent period is shorter for children, then for adults and lasts from 4 to 18 days, rarely – 8 weeks. Typical form starts acutely, unexpectedly or with the prodromal syndromes: shiver, sweating, anxiety, headache, myalgia (pains in muscles), depression and low appetite. Prodromal signs may last 1-2 weeks, then the triad occurs which is typical for infectious mononucleosis: fever, sore throat, enlarged lymph nodes.

Infectious mononucleosis triad:

fever

sore throat

enlarged lymph nodes

90% of patients have fever which lasts for 10-14 days and achieves maximum in the evenings (38-39C). The other picture may develop as well: subfebrile temperature all day long.

Tonsillitis is one of pathognomonic signs of the illness. Due to enlarged nasopharyngeal tonsils, nasal breath is difficult, stridor (harsh vibrating noise when breathing) occurs.

Simultaneously with mononucleosis tonsillitis pharyngitis of streptococcal origin may develop.

Polilymphadenopathy is a constant clinical sign of infectious mononucleosis. Sometimes, all the lymph nodes enlarge (generalized lymphadenopathy), sometimes lymphadenopathy occurs in one or two places (ex. in the area of neck and axillary crease, neck and groin). In case of generalized lymphadenopathy, mesenterial lymph nodes enlarge as well, due to which a patient has abdominal pains and sometimes, due to irritation of abdominal wall, nausea and vomiting start.