This virus infection typically spreads via oral to oral contact and is commonly called the “kissing disease.” It is caused most commonly caused by the Epstein-Barr virus also called Human Herpes Virus 4.
Generalized fatigue, feeling tired, or malaise can persist for 2-4 weeks.
A low grade fever is common with viral infections.
This disorder is often mistaken and treated as a “strep” type upper respiratory infection (URI) as symptoms are similar.
Patients experience a feeling of general malaise for several weeks after infection with complaints of head and body aches.
Classically, patients present with an enlarged spleen and liver. It is extremely important to advise patients with this virus to AVOID ALL contact sports due to the possibility of splenic rupture.
Swollen lymph glands in the neck and armpits are noted on assessment. The tonsils can be enlarged and appear red. In some instances, the tonsils may be covered with a membrane (similar to what is seen in diphtheria cases) and can lead to airway compromise due to swelling.
Most often this virus is mistaken for an upper respiratory bacterial type strep infection and is treated with medications like ampicillin or amoxicillin. Patients with infectious mononucleosis treated with ampicillin often develop a full body rash. New studies show that many patients who developed this rash have incorrectly believed they are allergic to penicillin type medications.
This may be an issue for some time after the disease; so patients should avoid live vaccines until several months after disappearance of symptoms.
Diagnosis of this virus is with the “Monospot” test which detects heterophilic antibodies in the patient’s serum.
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