12 Mononucleosis Symptoms

Mononucleosis, also known as mono or “the kissing disease”, is a viral infection caused by the Epstein-Barr virus (EBV). This infection is very common due to the fact that it is spread easily through the saliva of an infected person, by kissing, sharing a glass or food utensils, among others. Although EBV can infect people of all ages, it is more common in adolescents and young people. In fact, the Centers for Disease Control and Prevention (CDC) say that this infection is more common in schools and universities. Some people may develop a lot of symptoms, which is called mononucleosis syndrome. The symptoms are usually mild and the patient gets better with symptomatic treatment. However, many people don't experience any symptoms when infected, and the infection is only detected years later as a casual or accidental find. The following are the most common symptoms of mononucleosis syndrome: 1 Fever. Fever is a frequent symptom in mononucleosis, and rarely occurs on its own. It tends to be high, constant and difficult to control, and can reach temperatures of 103 or 104°F (39-40 °C). This symptom expresses the activation and the fight of the immune system against the Epstein-Barr virus. It is important to know that mononucleosis must always be considered among the causes of fever of unknown origin (FUO) and if it appears again after some weeks of normal temperature, the patient must consult a doctor to determine the cause and avoid any complication. 2 Sore throat. The sore throat, also called pharyngitis, is one of the main symptoms of mononucleosis. The throat inflammation can produce severe pain and difficulty to swallow and, in some cases, this symptom can be confused with the pharyngitis produced by the Streptococcus infection. The presence of petechiae (red, purple or brown spots on the skin, caused by a minor bleed from broken capillary blood vessels) in the veil of the palate is also very common but not exclusively from EBV infection. More symptoms on next page... 3 Inflamed lymph glands. Although all lymphatic chains can be affected by EBV infection, the mostly affected ganglion groups are the ones located in the armpits, neck, chest, groin and abdomen. This symptom is also caused by the activation of the immune system and its fight against the infection. The inflamed glands are always bilateral and symmetric. For example, if a patient has a neck ganglion inflamed in the right side, it will also have a ganglion inflamed in the left side too. If the patient has the posterior cervical ganglia bilaterally inflamed, it is highly suggestive of mononucleosis. Swelling of certain lymph nodes can last for many weeks, and in extreme cases even years, after the infection is overcome. It is important to know that, if a patient has these first 3 symptoms (fever, pharyngitis, and inflamed lymph glands), mononucleosis must be differentiated from other diseases that can also cause these symptoms, such as cytomegalovirus (CMV), acute infection by Human Immunodeficiency Virus (HIV), human herpesvirus 6 (HHV-6), hepatitis and toxoplasmosis. More symptoms on next page... 4 Headache. In mononucleosis, the headache is usually mild but persistent. When the patient has fever, it may become moderate-severe and it may be necessary to take over-the-counter painkillers to relieve it. 5 Fatigue. Fatigue is an important symptom of mononucleosis from the start of the infection. Many experts say that fatigue in mononucleosis is caused by all the systemic disorders (including alterations in the blood cells) that the virus may cause. Patients describe it as lack of energy or motivation to do something. This symptom is usually acute, but in some patients, it becomes chronic and lasts between 3 and 6 months. 6 Muscle weakness. This symptom is closely related to fatigue. Muscle weakness is not caused by neurological problems, but it is caused by fatigue and muscle inflammation. 7 Drowsiness. This symptom is also related to fatigue. Patients usually feel excessive drowsiness, which added to the fatigue, makes the them want to take a rest or sleep through the day. 8 Rash. This symptom is one of the first to appear; however, it is transient and it disappears after a few days. This symptom is usually mild-moderate, so in some cases it is not detected by the patients and it has disappeared when the patient visits the doctor. The rash caused by EBV doesn't cause itching and can be very small. It is important to know that this symptom is not specific to mononucleosis, so it is always important to visit a doctor to determine the correct diagnosis. 9 Loss of appetite. The patient usually skips meals and doesn't feel hungry. In fact, some patients can experience weight loss because they have this symptom for weeks or months. Some experts define the presence of fatigue, muscle weakness and loss of appetite like anicteric hepatitis, because the patient has no jaundice. However, the presence of other symptoms makes them think of mononucleosis and not hepatitis. 10 Enlarged spleen (splenomegaly) The enlargement of the spleen is closely related to inflamed lymph glands. It usually lasts for some weeks and disappears without being a problem, but some patients can experience a splenic rupture which is a severe complication of the disease. This symptom is also caused by other diseases. 11 Eyelid edema. It is considered a very specific symptom for infectious diseases, including the infection by EVB. In mononucleosis, it is always bilateral and only affects the upper-lid. This is an important difference with other infections that usually cause periorbital (upper and lower eyelids). 12 Meningoencephalitis. This is a very rare and severe complication of mononucleosis. Meningoencephalitis is a medical condition that resembles both meningitis (an infection or inflammation of the meninges) and encephalitis (an infection or inflammation of the brain). The patient starts feeling neurological manifestations and severe neck stiffness and headache, and must visit a doctor immediately. Please note: As the symptoms of mononucleosis can be very nonspecific, it can be confused with other diseases, including flu, dengue, tonsillitis, among others. So, if you have had some of these symptoms for more than a week, or they are severe, it is important to look for a doctor in order to obtain the proper diagnosis and treatment to avoid complications.

4 Headache

5 Fatigue

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