EBV is transmitted by saliva and droplet infection (airborne) with an incubation period of 2 weeks.
Symptoms and clinical picture of mononucleosis
The disease most commonly occurs in young adults and presents with fever, headache, sore throat. Pharyngitis, often the most prominent sign, can be accompanied by enlargement of the tonsils with an exudate resembling that of streptococcal pharyngitis. Petechiae (tiny bleeding spots) may occur in the soft palate.
A generalized lymph gland enlargement (particularly involving the posterior neck lymph glands) and an enlargement of the spleen are common. They are tender, symmetric but not fixed in place. Mild hepatitis is common.
A morbilliform or papular rash, usually on the arms or trunk, develops in about 5% of cases. Most patients treated with ampicillin develop a macular rash. Erythema nodosum and erythema multiforme have also been described.
Other diseases related to EBV infection
- Burkitt's lymphoma
- Nasopharyngeal carcinoma
- X-linked combined variable immunodeficiency
- Lymphoid interstitial pneumonia in children with AIDS.
Diagnosis of mononucleosis
Atypical lymphocytes are seen in the blood film. Paul - Bunnel and monospot tests are used to detect heterophil antibodies and are usually positive by the second week. Specific EBV IgM antibodies indicate a recent infection by the virus.
Treatment of mononucleosis
The disease may resolve alone in healthy subjects. Steroids (prednisolone) is advised when the condition is prolonged or accompanied by complications.