Mononukleose

Mononukleose, also known as infectious mononucleosis, is a viral illness caused most commonly by the Epstein-Barr virus (EBV). In some cases, other herpesviruses such as cytomegalovirus can produce a similar syndrome. It is primarily spread through saliva but can be transmitted through close contact with an infected person.

The illness typically presents with fever, sore throat with swollen tonsils, swollen lymph nodes in the neck and armpits, and marked fatigue. Additional findings may include headache, enlarged spleen, and, in some cases, liver involvement. A rash can occur, and abdominal discomfort or loss of appetite is possible. The illness is most common in adolescents and young adults, though it can occur at any age.

Diagnosis is based on clinical features supported by blood tests. A complete blood count often shows elevated white blood cells with atypical lymphocytes. A heterophile antibody test (Monospot) or EBV-specific serologies help confirm the infection, though early tests can be negative.

Management is supportive. Rest, fluids, and over-the-counter analgesics or antipyretics are standard. There is no proven antiviral treatment for uncomplicated EBV infection. Antibiotics are not effective against the virus; a rash may occur if certain antibiotics (notably ampicillin or amoxicillin) are given. Patients are advised to avoid contact sports for several weeks to reduce the risk of splenic rupture.

Most people recover within two to four weeks, though fatigue can persist longer. Complications are rare but can include splenic rupture, hepatitis, or airway obstruction from enlarged tonsils. There is no vaccine for mononukleose; prevention focuses on avoiding sharing utensils or drinks and close contact during acute illness.