Infectious mononucleosis is a benign, self-limiting, lymphoproliferative (originating in lymphoid cells) viral disease caused by the Epstein Barr virus (EBV). It is characterized by activation during periods of intense immunosuppression and transmission through saliva, which is why it is also called the “kissing disease”, and can also be spread through blood, transplants and sexual intercourse.
Symptoms of mononucleosis
During acute infection, the main symptoms of this virus are:
- Fever
- Sore throat
- Myalgia
- Headache (headache)
- Arthralgia (joint pain)
- Cough
- Nausea
- Vomiting
- Chills
- Hives
- Petechiae (small red lesions) on the roof of the mouth
- Swelling of the face
- Asthenia (general fatigue or weakness)
After acute infection, the virus remains in the pharynx for 18 months, although symptoms usually disappear within two to three weeks.
Complications of mononucleosis
Since the virus mainly affects the lymph nodes, liver, spleen and other viscera, complications can be:
- Neurological: meningitis, encephalitis, Guillian Barré syndrome, seizures.
- Respiratory: pleuritis (inflammation of the lining of the lungs) and upper airway obstruction.
- Hematologic: thrombopenia (decrease of platelets in the bloodstream), agranulocytosis (decrease in the number of neutrophils) and hemolytic and aplastic anemia.
- Splenic: rupture of the spleen.
- Cardiac: pericarditis (inflammation of the lining around the heart) and myocarditis (inflammation of the heart muscle).
- Hepatic: hepatic necrosis and hepatitis.
- Dermatological: vasculitis, acrocyanosis and rash due to aminopenicillins.
Treatment of mononucleosis
As previously reported, the disease is self-resolving in two or three weeks, but, to alleviate the symptoms, painkillers are used in dentistry and other specialties. In order to have a more bearable evolution of the virus and to avoid complications, some measures are recommended:
- Good hygiene by rinsing with saline solutions.
- A diet high in protein and low in fat.
- Rest
- Consume vitamin supplements
- Encourage the patient
- Prevent secondary infections
- Controlling sore throat with local anesthetics and chlorhexidine
- Avoid violent activities and contact sports