INFECTIOUS MONONUCLEOSIS

Infectious mononucleosis, often called “kissing disease,” is an acute viral infection caused primarily by the Epstein–Barr virus (EBV), a member of the herpesvirus family. It mainly affects adolescents and young adults and is transmitted through saliva, hence its association with kissing, as well as through coughing, sneezing, or sharing utensils.

After entering the body, EBV infects B lymphocytes and epithelial cells of the oropharynx, leading to a strong immune response by cytotoxic T lymphocytes. This immune reaction causes the typical symptoms of the disease.

The clinical features include fever, sore throat, malaise, and generalized lymphadenopathy, especially of the posterior cervical lymph nodes. Splenomegaly is common, and hepatomegaly may also occur. Some patients experience fatigue lasting for several weeks. In severe cases, complications such as splenic rupture, hemolytic anemia, or hepatitis may develop.

Diagnosis is based on clinical findings and laboratory tests. The Monospot test (heterophile antibody test) is commonly used, along with a complete blood count (CBC) showing atypical lymphocytosis. EBV-specific serological tests (like VCA-IgM and EBNA antibodies) can confirm infection.

There is no specific antiviral treatment; management is mainly supportive, including rest, hydration, and analgesics for fever and sore throat. Corticosteroids may be indicated in severe tonsillar enlargement or airway obstruction. Patients are advised to avoid contact sports for several weeks to prevent splenic rupture.