Infectious mononucleosis

Infectious mononucleosis (IM, mono), also known as glandular fever, is an infection usually caused by the Epstein–Barr virus (EBV).[2][3] Most people are infected by the virus as children, when the disease produces few or no symptoms.[2] In young adults, the disease often results in fever, sore throat, enlarged lymph nodes in the neck, and tiredness.[2] Most people recover in two to four weeks; however, feeling tired may last for months.[2] The liver or spleen may also become swollen,[3] and in less than one percent of cases splenic rupture may occur.[6]

Infectious mononucleosis
Other namesGlandular fever, Pfeiffer's disease, Filatov's disease,[1] kissing disease
Swollen lymph nodes in the neck of a person with infectious mononucleosis
SpecialtyInfectious disease
SymptomsFever, sore throat, enlarged lymph nodes in the neck, tiredness[2]
ComplicationsSwelling of the liver or spleen[3]
Duration2–4 weeks[2]
CausesEpstein–Barr virus (EBV) usually spread via saliva[2]
Diagnostic methodBased on symptoms and blood tests[3]
TreatmentDrinking enough fluids, getting sufficient rest, pain medications such as paracetamol (acetaminophen) and ibuprofen[2][4]
Frequency45 per 100,000 per year (U.S.)[5]

While usually caused by the 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.[3] It is primarily spread through saliva but can rarely be spread through semen or blood.[2] Spread may occur by objects such as drinking glasses or toothbrushes or through a cough or sneeze.[2][7] Those who are infected can spread the disease weeks before symptoms develop.[2] Mono is primarily diagnosed based on the symptoms and can be confirmed with blood tests for specific antibodies.[3] Another typical finding is increased blood lymphocytes of which more than 10% are atypical.[3][8] The monospot test is not recommended for general use due to poor accuracy.[9]

There is no vaccine for EBV, though promising vaccine research results exist.[10] Infection can be prevented by not sharing personal items or saliva with an infected person.[2] Mono generally improves without any specific treatment.[2] Symptoms may be reduced by drinking enough fluids, getting sufficient rest, and taking pain medications such as paracetamol (acetaminophen) and ibuprofen.[2][4]

Mononucleosis most commonly affects those between the ages of 15 to 24 years in the developed world.[8] In the developing world, people are more often infected in early childhood when there are fewer symptoms.[11] In those between 16 and 20 it is the cause of about 8% of sore throats.[8] About 45 out of 100,000 people develop infectious mono each year in the United States.[5] Nearly 95% of people have had an EBV infection by the time they are adults.[5] The disease occurs equally at all times of the year.[8] Mononucleosis was first described in the 1920s and is colloquially known as "the kissing disease".[12]

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