Disease States: Mononucleosis

Testing can help your accounts accurately diagnose their patients.

Mononucleosis (mono) most commonly affects adolescents and young adults. Young children generally have few symptoms, and older adults often are immune to the disease. Although mono isn’t as contagious as some infections, including the common cold, it can be transmitted through saliva (hence, one of its nicknames, the kissing disease), as well as through a cough or sneeze, or by sharing a glass, utensils or a toothbrush with an infected person, according to Mayo Clinic.

Mono is caused by the Epstein-Barr virus (EBV) and may lead to the following symptoms:

• Fatigue
• General feeling of being unwell
• Sore throat, or a strep throat that doesn’t respond to antibiotic treatment
• Fever
• Swollen lymph nodes in one’s neck or armpits
• Swollen tonsils
• Headache
• Skin rash
• Soft, swollen spleen

Usually, mono isn’t serious and can be addressed with rest and a healthy diet. However, sometimes complications of the disease can become quite serious. Mono can cause enlargement of the spleen, according to Mayo, and in severe cases the spleen may rupture. It can also lead to hepatitis (mild liver inflammation) and jaundice (yellowing of the skin and whites of the eyes). Complications that are less common include:

• Anemia
• Thrombocytopenia. (Low count of platelets, which aid in clotting)
• Heart problems
• Complications involving the nervous system
• Swollen tonsils, which can block breathing

Traditionally, physicians have relied on a couple of testing methods to diagnose mononucleosis, according to WebMD.com:

• Monospot test (heterophil test). A quick screening blood test detects the heterophil antibody, which forms during certain infections. The presence of heterophil – and blood clumping on the test slide – often indicates mono infection. The test generally detects antibodies between two and nine weeks after a person is infected. Other infectious diseases, such as cytomegalovirus, leukemia or lymphoma, rubella, hepatitis or lupus, which have symptoms similar to those of mono, can result in a negative monospot test.
• EBV antibody test. If the monospot test result is negative, but mono symptoms are present, an EBV blood test can be done to check for antibodies to EBV. Testing within the first few weeks of becoming infected with EBV can lead to a false-negative result.

In addition to prescribing rest, a healthy diet, fluids and over-the-counter pain relievers if necessary, physicians commonly treat symptoms such as strep, sinus infection and /or tonsillitis with antibiotics. (Taking penicillin derivatives can cause some patients to develop a rash.)