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.

传染性单核细胞增多症（infectious mononucleosis）常被称为"接吻病"，是一种主要由疱疹病毒科成员EB病毒（Epstein–Barr virus，EBV）引发的急性病毒性感染。该病主要累及青少年与年轻群体，可通过唾液传播，因此得名"接吻病"，也可经咳嗽、打喷嚏或共用餐具等途径传染。

EB病毒侵入人体后，会感染B淋巴细胞（B lymphocyte）和口咽部上皮细胞，引发细胞毒性T淋巴细胞（cytotoxic T lymphocyte）介导的强烈免疫应答，该免疫反应正是该病典型症状的诱因。

该病的临床表现包括发热、咽痛、乏力以及全身性淋巴结肿大，尤以颈后淋巴结肿大为著。脾大较为常见，亦可出现肝大。部分患者会持续数周的疲劳感。重症病例可出现脾破裂、溶血性贫血或肝炎等并发症。

该病的诊断需结合临床表现与实验室检查。临床常用莫诺斑试验（Monospot test，异嗜性抗体试验），联合全血细胞计数（complete blood count，CBC）可见非典型淋巴细胞增多。EB病毒特异性血清学检测（如VCA-IgM与EBNA抗体）可确诊感染。

目前尚无针对性的抗病毒治疗手段，临床管理以支持治疗为主，包括休息、补液以及针对发热与咽痛的镇痛治疗。若出现严重扁桃体肿大或气道梗阻，可考虑使用糖皮质激素。建议患者数周内避免接触性运动，以防发生脾破裂。