mononucleose

Mononucleose, also called infectious mononucleosis or glandular fever, is a clinical syndrome most often caused by infection with the Epstein-Barr virus (EBV). It commonly affects adolescents and young adults, though it can occur at any age. The typical presentation includes fever, sore throat with tonsillar enlargement, swollen lymph nodes (especially in the neck), fatigue, and sometimes an enlarged liver or spleen. Patients may also experience headache, malaise, and mild abdominal discomfort.

EBV is primarily transmitted through saliva and other body fluids. After an incubation period of about 4 to 6 weeks, symptoms develop. The illness is usually self-limited, with most people recovering within a few weeks, though fatigue can persist for weeks to months. Complications are uncommon but can include splenic enlargement with a risk of rupture, airway obstruction from enlarged tonsils, dehydration, and, rarely, neurologic or hepatic disorders.

Diagnosis relies on clinical assessment supported by laboratory tests. White blood cell counts often show lymphocytosis with atypical lymphocytes. A heterophile antibody test (Monospot) is commonly positive in adolescents and adults, but it may be negative early in the illness; EBV-specific serology can confirm the infection. Liver enzymes may be elevated.

Management is supportive: adequate hydration, rest, analgesics and antipyretics as needed. Strenuous activity and contact sports should be avoided for about 3 to 4 weeks to reduce splenic rupture risk. Antibiotics do not treat EBV infection; if a secondary bacterial tonsillitis is suspected, appropriate antibiotics may be used, though ampicillin or amoxicillin commonly induce a nonallergic rash in EBV infection.

There is no vaccine for mononucleose. Prevention focuses on hygiene to reduce transmission, while diagnosis and management distinguish it from other causes of fever and pharyngitis.