INFECTIOUS MONONUCLEOSIS
SYNONYMS:
Glandular fever
Kissing disease
INTRODUCTION:
It is defined as a benign, self-limiting lymphoproliferative disease caused by
Epstein-Barr virus.
Most prevalent human viruses in the world.
90% of the global population - seropositive for EBV.
Transmission by person-to-person contact such as by kissing with transfer of
vitally contaminated saliva.
ETIOLOGY:
Caused by Epstein-Barr virus (EBV).
Also known as human herpes virus 4 - widely disseminated double stranded
DNA herpesvirus.
PATHOPHYSIOLOGY:
MODES OF TRANSMISSION:
⬧ Via intimate contact with body secretions, primarily oropharyngeal
secretions, lesser degree through genital secretions.
⬧ Via blood transfusion and organ transplantation – rare.
Infects B lymphocytes results in a humoral and cellular response.
Humoral immune response directed against EBV structural proteins - test used
to diagnose EBV infectious mononucleosis.
T-lymphocyte cellular response - critical in determining the clinical expression of
EBV infection.
Natural killer (NK) cells and predominantly CD8+ cytotoxic T cells control
proliferating B lymphocytes infected with EBV.
Ineffective T-cell response - excessive and uncontrolled B-cell proliferation,
resulting in B-lymphocyte malignancies (e.g., B-cell lymphomas).
Immune response to EBV infection - fever - cytokine release.
CLINICAL FEATURES:
Incubation period – 4- 6 weeks.
Most patients – asymptomatic.
Almost all patients with EBV infectious mononucleosis - fatigue and prolonged
malaise.
Sore throat - second only to fatigue and malaise.
Fevers may reach 103-104°F - usually less than 102°F.
Arthralgias and myalgias occur - less common than other viral infections.
Nausea and anorexia, without vomiting – common.
SYNONYMS:
Glandular fever
Kissing disease
INTRODUCTION:
It is defined as a benign, self-limiting lymphoproliferative disease caused by
Epstein-Barr virus.
Most prevalent human viruses in the world.
90% of the global population - seropositive for EBV.
Transmission by person-to-person contact such as by kissing with transfer of
vitally contaminated saliva.
ETIOLOGY:
Caused by Epstein-Barr virus (EBV).
Also known as human herpes virus 4 - widely disseminated double stranded
DNA herpesvirus.
PATHOPHYSIOLOGY:
MODES OF TRANSMISSION:
⬧ Via intimate contact with body secretions, primarily oropharyngeal
secretions, lesser degree through genital secretions.
⬧ Via blood transfusion and organ transplantation – rare.
Infects B lymphocytes results in a humoral and cellular response.
Humoral immune response directed against EBV structural proteins - test used
to diagnose EBV infectious mononucleosis.
T-lymphocyte cellular response - critical in determining the clinical expression of
EBV infection.
Natural killer (NK) cells and predominantly CD8+ cytotoxic T cells control
proliferating B lymphocytes infected with EBV.
Ineffective T-cell response - excessive and uncontrolled B-cell proliferation,
resulting in B-lymphocyte malignancies (e.g., B-cell lymphomas).
Immune response to EBV infection - fever - cytokine release.
CLINICAL FEATURES:
Incubation period – 4- 6 weeks.
Most patients – asymptomatic.
Almost all patients with EBV infectious mononucleosis - fatigue and prolonged
malaise.
Sore throat - second only to fatigue and malaise.
Fevers may reach 103-104°F - usually less than 102°F.
Arthralgias and myalgias occur - less common than other viral infections.
Nausea and anorexia, without vomiting – common.
