Infectious mononucleosis Flashcards
(13 cards)
What is infectious mononucleosis?
A condition caused by infection with the Epstein Barr virus (EBV).
What is infectious mononucleosis also known as?
Commonly known as the ‘kissing disease’, ‘glandular fever’ or ‘mono’.
How can EBV spread?
The virus is found in the saliva of infected individuals and may be spread by kissing or by sharing cups, toothbrushes, and other equipment that transmits saliva.
What happens when EBV is in the saliva?
EBV is secreted in the saliva of infected individuals and can be infectious several weeks before the illness begins and intermittently for the remainder of the patient’s life.
Who is more symptomatic, children or teens?
Most people are infected with EBV as children, causing very few symptoms. When infection occurs in teenagers or young adults, it causes more severe symptoms.
What can cause a rash in response to infectious mononucleosis?
Mononucleosis causes an intensely itchy maculopapular rash in response to amoxicillin or cefalosporins.
What are the features of infectious mononucleosis?
Fever, sore throat, lymphadenopathy (swollen lymph nodes), splenomegaly and in rare cases splenic rupture, fatigue, tonsillar enlargement.
What antibodies are produced and how long does it take to produce them?
In infectious mononucleosis, the body produces heterophile antibodies, which are multipurpose and not specific to EBV antigens. It takes up to 6 weeks for these antibodies to be produced.
How can we test for heterophile antibodies?
Monospot test: introduces the patient’s blood to red blood cells from horses. Heterophile antibodies (if present) will react to the horse red blood cells and give a positive result. Paul-Bunnell test: similar to the monospot test but uses red blood cells from sheep.
How do we test for specific EBV antibodies and what do they produce?
It is possible to test for specific EBV antibodies targeting viral capsid antigen (VCA): The IgM antibody rises early and suggests acute infection; the IgG antibody persists after the condition and suggests immunity.
What is the prognosis for infectious mononucleosis?
Infectious mononucleosis is usually self-limiting. The acute illness lasts around 2 – 3 weeks, but it can leave the patient with fatigue for several months once the infection is cleared.
What is the management for infectious mononucleosis?
Patients are advised to avoid alcohol, as EBV impacts the ability of the liver to process alcohol. Patients should also avoid contact sports due to the risk of splenic rupture for 4 weeks. Emergency surgery is usually required if splenic rupture occurs.
What are the complications of infectious mononucleosis?
Splenic rupture, glomerulonephritis, haemolytic anaemia, thrombocytopenia, chronic fatigue. EBV infection is associated with certain cancers, notably Burkitt’s lymphoma.
