Infectious mononucleosis diagnosed by downey cells. Cmv mononucleosis is estimated to comprise 7% of all infectious mononucleosis syndromes. Like ebv, it belongs to the herpes virus family, usually causes an asymptomatic infection early in life in most individuals, and then lies dormant and remains within the host for life. It typically occurs in teenagers, but you can get it at any age. Pathophysiology and clinical presentation correct diagnosis infectious mononucleosis is a highly contagious viral disease caused by the epsteinbarr virus ebv. Infectious mononucleosis mostly affects teenagers and young. Infectious mononucleosis is a highly contagious viral disease caused by the epsteinbarr virus ebv.
Diagnosis of infectious mononucleosis because of primary ebv infection. Some data derived in the united kingdom suggest that infectious mononucleosis im cases may be occurring later in life with increasing severity, requiring hospitalization. Read about infectious mononucleosis mono treatment, symptoms, signs, risks, and diagnosis. Returning to your usual schedule too soon can increase the risk of a relapse.
Infectious mononucleosis is a acute infectious disease, caused by epsteinbarr virus evb that belongs to the herpesviridae. Classic physical findings include fever, splenomegaly, pharyngitis, and lymphadenopathy. Always consult your childs physician for a diagnosis. Most signs and symptoms of mononucleosis ease within a few weeks, but it may be two to three months before you feel completely normal. Typical symptoms of infectious mononucleosis usually appear four to six weeks after you get infected with ebv. The symptoms of the mononucleosis may resemble other medical conditions. While i have no arguments with this general concept, i would like to answer certain criticisms raised by dr. A typical clinical picture in an adolescent or young adult with a positive heterophile test is usually sufficient to make the diagnosis of infectious. Mononucleosis is not considered a serious illness, but its symptoms may be severe enough to prevent a person from engaging in normal activities for several weeks. If acute hiv infection is suspected, a quantitative polymerase chain reaction test should be performed. Jul 01, 2001 prompt communication between the hematology laboratory and the attending physicians resulted in the diagnosis of atypical infectious mononucleosis for 17 patients for whom the diagnosis of infectious mononucleosis was not suspected. Common questions about infectious mononucleosis jason womack, md, and marissa jimenez.
Mononucleosis mono is an infectious disease caused most often by the. Infectious mononucleosis, or mono, refers to a group of symptoms usually caused by the epsteinbarr virus ebv. Sore throat, fever, rash malaise, lethargy, extreme tiredness liver and spleen involvement and enlargement hematology. F is a generally healthy 19yearold college student. However, posterior cervical or generalized adenopathy or hepatosplenomegaly suggests. Mononucleosis tests including the monospot test and ebv antibody test are blood tests. Oct 17, 2017 mononucleosis, or mono, has a wide range of symptoms, which can make it hard to diagnose.
The differential diagnosis for suspected infectious mononucleosis is summarized in table 1. Ebv is found worldwide and infects about 90% of people by adulthood, although most people never show symptoms centers for disease control and prevention cdc, 2014. Infectious mononucleosis, also called mono, is a contagious disease. John dirckx called attention to the need for observance of strict criteria for the diagnosis of infectious mononucleosis. What test is the best for diagnosing infectious mononucleosis. Nov 26, 2012 because leukocytosis is the rule in infectious mononucleosis, the presence of a normal or decreased wbc count should suggest an alternative diagnosis. We believe that simply doing a full blood count with a manual differential is a rapid test that, as was true in 1923, can be a useful way of establishing a diagnosis of infectious mononucleosis. Pediatric infectious mononucleosis childrens national. Initial testing with a cbclooking for atypical lymphocytes which after several days replace the early granulocytic response and a heterophile antibody titeris a reasonable strategy. The more rest you get, the sooner you should recover.
Ebv is in the herpes virus family, and is also known as human herpes virus type 4. It is possible for the monospot test to come back negative early in the course of the infections false negative. It can be caused by a number of pathogens, but this chapter considers it as disease resulting from primary epsteinbarr virus ebv infection and is focused on the immunocompetent host. Your doctor may suspect mononucleosis based on your signs and symptoms, how long theyve lasted and a physical examination. The disease is spread through saliva and can cause fever, sore throat, and swollen lymph nodes. It is mostly common among the teenagers and young people.
Most people are infected by the virus as children, when the disease produces few or no symptoms. Large studies of infectious mononucleosis are now decades old, but traditionally, the peak incidence of infection has been described in the 15 to 24year age range. Patients presenting with fever and swollen lymph glands with complaints of sore throat and recent fatigue provide rationale for this differential diagnosis. Complete blood count cbc may be done to help confirm the diagnosis of mono and rule out other infections or complications of mono. Infectious mononucleosis mono is often called the kissing disease. Mononucleosis university health services university of california. Infectious mononucleosisaka mono what is infectious mononucleosis. It is common among teenagers and young adults, especially college students. At least one out of four teenagers and young adults who get infected. Objective after presenting a case of severe infectious mononucleosis, the spectrum of disease is given. Symptoms may develop slowly and may not all occur at the same time. Infectious mononucleosis approach bmj best practice. Many people who get mono do not even know they have it. Diagnosis of infectious mononucleosis by currently available testing remains somewhat problematic, especially early in the course of the illness.
The diagnosis infectious mononucleosis is primarily used when the syndrome is caused by ebv. Diagnosis of infectious mononucleosis to the editor. Infectious mononucleosis should be suspected in patients with typical symptoms and signs. The virus that causes mono is transmitted through saliva, so you can get it through kissing, but you can also be exposed through a cough or sneeze, or by sharing a glass or food utensils with someone who has mono. Infectious mononucleosis is transmitted by exposure to saliva, so it can be spread by kissing, by sharing glasses or cutlery, and by droplets spread by coughing.
Learn more about the symptoms of coronavirus covid19, how you can protect your family, and how nationwide childrens hospital is preparing. Epsteinbarr virus encephalomyelitis diagnosed by polymerase chain. There is a practical way and a precise way to diagnose infectious mononucleosis because of primary ebv infection. Mononucleosis mono is an infectious disease caused most often by the epsteinbarr virus ebv. Infectious mononucleosis is a clinical diagnosis, caused by epsteinbarr virus in 90% of cases, although in some patients pregnancy, high risk.
Rtpcr and measurement of ebvvl may provide useful tools for the early diagnosis of infectious mononucleosis in cases with inconclusive serological results vouloumanou et al. Lymphocyte subsets from whole blood were examined in 25 acute infectious mononucleosis patients with facsort flow cytometer. Infectious mononucleosis im is characterized by a triad of fever. Jan 18, 2020 however, if dnabased investigations are not available, then it might be necessary to rely on the more tried and tested traditional method. Your doctor can advise on treatment for symptoms such as fever and sore throat. Diagnostic evaluation of mononucleosislike illnesses american. Infectious mononucleosis page 1 of 2 communicable diseases factsheet infectious mononucleosis mostly affects teenagers and young adults. Mononucleosis, or mono, has a wide range of symptoms, which can make it hard to diagnose.
Illness usually lasts between one week and several weeks. Discussion the majority of cases of infectious mononucleosis are self limiting and require. A blood test can confirm the diagnosis in a patient who is suspected to have infectious mononucleosis. The kissing disease is a contagious sickness caused by the epstein barr virus, which is transmitted in saliva. Positive heterophile antibody test and serologic test for antibodies against ebv are usually diagnostic. Infectious mononucleosis mono is an infection that causes sore throat, fever, swollen glands, and tiredness or fatigue. Feb 27, 2015 diagnosis of infectious mononucleosis because of primary ebv infection. Epsteinbarr virus ebv is the most common cause of infectious mononucleosis, but other viruses can also cause this disease. Symptoms may develop slowly and may not all occur at. Lab logic diagnosis of infectious mononucleosis by cathy r. History and pathophysiology infectious mononucleosis was first described in the 19th century as drusenfieber, or glandular fever, owing to its clinical presentation of fever with lymphadenopathy and splenomegaly. Infectious mononucleosis symptoms, diagnosis and treatment. Infectious mononucleosis is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue and fever.
Pathophysiology and clinical presentation correct diagnosis. Infectious mononucleosis msd manual professional edition. Differential diagnosis of infectious mononucleosis. Current diagnosis and management of infectious mononucleosis. As a consequence, no additional tests and no therapy were prescribed. Mono is usually a mild illness that goes away without treatment after several weeks. Youll need to see your doctor to find out if you have. Mono is an extremely common illness in children and young adults, with many cases being mild and resolving promptly without the patient feeling sick enough to.
Jun 21, 2015 infectious mononucleosis 4 to 7 week incubation acute selflimiting infection of the re system enlarged lymph nodes in the neck. High wbc, over 20% atypical reactive lymphocytes also known as downey cells. Lymphocytosis accompanies infectious mononucleosis, increases during the first few weeks of illness, and then gradually returns to normal. Differential diagnoses infectious mononucleosis im. It is most commonly caused by the epsteinbarr virus ebv. Mononucleosis, also known as mono, is an infectious disease that is usually caused by the epsteinbarr virus a herpes virus. Diagnosis of atypical cases of infectious mononucleosis. Exudative pharyngitis, anterior cervical lymphadenopathy, and fever may be clinically indistinguishable from those caused by group a betahemolytic streptococci.
More severe cases and unusual complications occasionally occur. Infectious mononucleosis is a clinical diagnosis, caused by epsteinbarr virus in 90% of cases, although in some patients pregnancy, high risk hiv population further investigations are warranted. Infectious mononucleosis im, mono, also known as glandular fever, is an infection usually caused by the epsteinbarr virus ebv. Sore throat, perhaps misdiagnosed as strep throat, that doesnt get better after treatment with antibiotics. Typical features of infectious mononucleo sis include fever, pharyngitis, adenopathy, malaise, and an atypical lymphocytosis. Mononucleosis syndromes infectious disease advisor. Infectious mononucleosis im is a common childhoodadolescent illness. A heterophile antibody test for epsteinbarr virusinduced infectious mononucleosis is negative. The patient was also instructed not to drink alcohol and to use good hygiene practices and avoid sharing food or beverages. Typical symptoms of infectious mononucleosis usually appear 46 weeks after you get infected with ebv. Lab logic the diagnosis of infectious mononucleosis, instructed to rest as much as possible, and to avoid contact sports for 1 month. There is no specific treatment for infectious mononucleosis. Characterized by the classic triad of fever, pharyngitis, and lymphadenopathy, along with atypical lymphocytosis. Learn from the experts at webmd how to spot the signs of mono and get the right treatment.