Infectious mononucleosis (IM or Mono) is usually caused by the Epstein–Barr virus (EBV), which is a member of the herpes virus family. This virus was discovered by the renowned Russian pediatrician Nil Filatov in 1885. IM is characterized by a triad of symptoms: fever, tonsillar pharyngitis, and lymphadenopathy. It is primarily spread through saliva, and those who are infected can spread the disease weeks before symptoms develop. Spreading may occur through objects such as drinking glasses or toothbrushes and can be prevented by not sharing personal items or kissing infected individuals. Drinking enough fluids, getting sufficient rest, and taking pain medications such as acetaminophen and ibuprofen are the best recommendations. There is no vaccine for EBV, and mono generally gets better on its own.
Mono is primarily diagnosed based on the symptoms and can be confirmed with blood tests for specific antibodies. Another typical finding is increased blood lymphocytes, of which more than 10% are atypical. Mono most commonly affects those between the ages of 15 to 24 years in the developed world. In the developing world, people are more often infected in early childhood when the symptoms are less severe. In those between ages 16 and 20 years, it is the cause of about 8% of sore throats. Mononucleosis was first described in the 1920s and is generally known as the kissing disease. The relationship between EBV and IM was established when a laboratory worker was infected with EBV and developed IM. A few other viruses may also cause the disease.
The background, pathogenesis, clinical manifestation, diagnosis, and treatment of IM in adults and adolescents will be briefly reviewed in this article.
