What is infectious mononucleosis, its symptoms and treatments

Mononucleosis is a viral infectious disease that affects the palatine tonsils and uvula, nasopharynx, lymph nodes, liver, spleen and affects the composition of the blood. In addition to infectious mononucleosis, this disease is called “glandular fever” and “monocytic angina.” Below you will learn how this disease is transmitted, about the methods of its diagnosis and treatment. And also we will talk about the ways of transmission and symptoms of the disease. But first, let’s take a closer look at what infectious mononucleosis is and what causes it.


The causative agent of infectious mononucleosis is from the group of herpesviruses, and is the herpesvirus type 4, which is called the Epstein-Barr virus. In addition to infectious mononucleosis, Epstein-Barr causes a number of diseases ranging from chronic fatigue syndrome to hepatitis.

There are five main methods of infection, let’s look at how mononucleosis is transmitted:

Direct contact and household transmission. In the contact form, the virus is transmitted, most often through saliva. When the saliva of an infected person gets on household items, upon contact with it, it is the subject of damage to a new organism.

Airborne way. The virus itself is not resistant to the open environment, so in order for the virus to enter a new organism through the air, close contact with an infected person is necessary.

From mother to fetus. During pregnancy, in the case of an acute form of the disease or primary infection, it is likely that the infection will penetrate the placenta to the fetus.

Through donor links. The possibility of becoming infected is present during the transfusion of infected blood or transplantation of donor organs.

Through a kiss Kisses were specifically highlighted in a separate paragraph, despite the fact that it has already been written above about a possible infection through the saliva of an infected person. Mononucleosis is called “kissing disease” because it is one of the most common ways mononucleosis is spread and the reason for its widespread occurrence in adolescents.

The incubation period for mononucleosis can be up to three weeks, but most often it is a week. The disease itself lasts about two months. A feature of the causative agent of mononucleosis is the active spread among adolescents and large crowds of people, so people are often infected in groups while in hostels, schools or kindergartens.

Viral mononucleosis often causes an acute form of the disease in young children and adolescents. This is due to the primary infection, which affects children. Mononucleosis in adults also has a place to be, but mainly with a relapse of a chronic disease.


Symptoms of mononucleosis may not always be accurate, so many doctors with infectious mononucleosis diagnose a common sore throat and are mistaken, and later, after the appearance of obvious mononucleosis symptoms, they realize that they made the wrong decision.

General symptoms

Consider the general symptoms of the disease:

there is an increase in lymph nodes;

mild malaise;


muscle pain;

joints begin to hurt;

at the beginning of the disease, the temperature rises slightly;

later the temperature rises to 39 – 40 degrees;

painful to swallow;

about a day, body temperature can decrease and increase in jumps;

tonsillitis appears;

stomach ache, diarrhea or vomiting;

enlargement of the spleen and liver.

Local symptoms

Symptoms of infectious mononucleosis associated with the throat. With mononuclear angina, as it is also called ” mononuclear angina”, there is an increased thickening of mucus in the nasopharynx, which drains down the back of the throat noticeably for a person. The throat begins to hurt, the tonsils become inflamed, it is difficult to breathe due to problems associated with mucus secretions from the nasopharynx. Tonsillitis begins, which can manifest itself with severe swelling of the tonsils, sometimes the swelling is weak, indicating catarrhal tonsillitis. Tonsils are covered with plaque.

Signs of mononucleosis associated with lymph nodes. With mononucleosis , inflammation of the lymphatic cervical zones at the back and submandibular lymph nodes is observed. The increase in nodes in these areas can reach three centimeters. In addition to the submandibular and cervical lymphatic systems, lymph nodes in the inguinal and axillary regions can sometimes be affected. The photo under No. 1 and 2 shows enlarged lymph nodes with infectious mononucleosis.

In some cases, a rash may appear. The rash appears about five days after the onset of the disease and lasts for three days. The rash may be pigmented in the form of spots. The photo under No. 3 shows how a mononucleosis rash manifests itself in adults. And in the photo under number 4, you can see how mononucleosis sleeps in children.

In addition to the typical manifestations, with infectious mononucleosis, there may be no symptoms at all, which indicates an atypical form of the course of the disease.


Chronic mononucleosis is the course of an already established infection in the body of people who are carriers. Under certain circumstances, which are associated with the suppression of the immune system, a relapse of the disease is manifested. At the same time, a decrease in immunity can be due to many factors, including depression and maintaining an unhealthy lifestyle. In addition, a chronic form may appear due to diseases.

With exacerbation, chronic mononucleosis is expressed by the following symptoms:

all the same migraines and muscle pains;

general weakness of the body;

in some cases, the spleen is enlarged, slightly less than with primary infection;

lymph nodes increase in the same areas as in the acute form;

at the same time, body temperature is most often normal;

sometimes there is nausea and abdominal pain.

Due to the peculiarities of the chronic form of infectious mononucleosis, the disease is observed in adults. At the same time, there is a connection between the activation of the Epstein-Barr virus and frequent recurrences of colds on the lips and genital herpes. That is, people who experience persistent manifestations of cold sores of herpes types 1 and 2 are more likely to develop a secondary disease of mononucleosis.


Diagnosis of infectious mononucleosis is necessary due to the difficult detection of the disease due to typical symptoms, since external symptoms resemble many diseases, including tonsillitis and SARS.

Consider the main methods of laboratory diagnosis of infectious mononucleosis:

General blood analysis. Mononuclear cells appear in the peripheral circulatory system of an infected person , these are lymphocytes in which certain changes occur under the influence of the Epstein-Barr virus. Healthy people do not have these cells.

PCR (polymerase chain reaction). This type of diagnostic is used to detect the Epstein-Barr virus in the body. PCR will detect the DNA of the Epstein-Barr virus and will clarify the stage of the disease.

Pharyngoscopy at Laura. Diagnosis of mononucleosis using pharyngoscopy is necessary in order to distinguish monocytic angina from another type of angina, for this you should definitely visit an otolaryngologist.

It is possible to differentiate mononucleosis from SARS and tonsillitis by nasal congestion and snoring breathing. With angina or SARS, there is a common runny nose, which does not give symptoms in the form of difficult breathing. If it is too late to diagnose infectious mononucleosis during the initial infection and treatment is not started on time, it can become chronic and reduce immunity.


Treatment for infectious mononucleosis primarily focuses on managing the symptoms. You will not find how to treat mononucleosis in the form of a specific scheme anywhere, since there is no treatment plan. But there are some aspects that are aimed at fighting the affected organs and raising the body’s defense mechanisms.

It is worth highlighting that in case of complications, high temperature and general intoxication of the patient’s body, the patient is hospitalized. But most often, the treatment of mononucleosis takes place on an outpatient basis.

Consider how infectious mononucleosis is treated, highlighting several areas and drugs:

Vitamin therapy is needed to help the immune system fight infection.

Antipyretics – to combat high fever.

Antibiotics – in some cases, metronidazole is prescribed to combat inflammation in the throat.

Splenectomy (removal of the spleen) – is performed when the spleen is damaged during an illness, if there are no doctors nearby when the organ ruptures, a fatal outcome is possible.

Tracheostomy (hole in the trachea) – is done in case of a severe complication with breathing, it also requires surgical intervention by doctors.

Choleretic drugs – in case of liver damage.

Proper nutrition – a diet for mononucleosis is necessary to correct the metabolism, which is disturbed due to illness. At the same time, fresh bread and pastries, everything fatty and fried, caviar, acidic fruits and vegetables, ice cream and chocolate are prohibited.

As can be seen from the above list, the treatment is aimed at the pathology of the organs that were affected by mononucleosis. And also to support the immune system. In addition, constant rest is necessary until the symptoms associated with sore throats and high body temperature pass. The acute stage of the disease usually resolves within two weeks. But the general condition of the body can be weakened for a few more months.


The peculiarity of infectious mononucleosis during childbearing is that all of the above listed lesions of internal organs and the general serious condition of the expectant mother can seriously affect the fetus. Some write that mononucleosis during pregnancy is not dangerous for the fetus, but this is not so.

Experts recommend refraining from planning pregnancy for six months after suffering mononucleosis. And it doesn’t matter who was sick, a woman or a man. If the disease has aggravated already during pregnancy, then this threatens with a miscarriage if mononucleosis occurs in a severe form. In severe cases of the disease, doctors often insist on artificial termination of pregnancy.

Symptoms in women in position are the same as in other adults. All the same problems with the lymph nodes, throat, the general well-being of the body is in a depressed state, problems with breathing and internal organs. With a mild form of mononucleosis, treatment is carried out by the same methods as described above, there is a fight against symptoms, but with an emphasis on pregnancy.

Of the recommendations for expectant mothers, you can be advised to urgently undergo a diagnosis with your attending gynecologist to confirm the diagnosis, since, as mentioned above, mononucleosis can be easily confused with tonsillitis or SARS. And all other recommendations on drugs and methods of treatment should be received only from a doctor, so as not to aggravate the situation and not harm the fetus.


With infectious mononucleosis, complications are extremely rare, but if they do, they pass in a very severe form and in some cases lead to the death of the patient. Some of the consequences of mononucleosis are given in the treatment methods, but let’s look at all the possible complications of this disease:

rupture of the spleen – often leads to death if you do not have time to do an operation to remove it;

autoimmune hemolytic anemia;

from the field of neurology – in this case, encephalitis, damage to the facial nerve and nerves of the cranial region, meningoencephalitis, polyneuritis may occur;

liver problems, including hepatitis;

Burkitt ‘s lymphoma – a complication occurs in the form of a granuloma and is associated with the Epstein-Barr virus.

With complications of mononucleosis, liver damage is often isolated, a slight decrease in the number of platelets, which leads to a problematic stoppage of blood. As well as a severe form of granulocytopenia , which occurs in the form of reduced granulocytes in the blood, which increases the possibility of death.

With liver damage, only the formation of hepatitis, which forms an icteric type of mononucleosis, is considered a complication. A strong increase in the lymph nodes that pass near the trachea can lead to serious complications of the respiratory tract. Usually, death occurs only when the spleen ruptures and complications in the form of encephalitis.


Prevention of mononucleosis is aimed only at maintaining the immune system in a stable state and in understanding the ways of transmission of infection. To maintain immunity, you need to lead a healthy lifestyle. And understanding the ways of transmission of infectious mononucleosis, you must follow the rules that do not allow an infected person to pass the disease to you.

In infectious mononucleosis, there is no prophylaxis that targets the virus directly. It is necessary to remember what mononucleosis is and what causes it. That’s right, this disease is caused by the Epstein-Barr virus, and against it there are no vaccines or antiviral drugs specifically aimed at combating this strain of the virus. Therefore, you should adhere to the general preventive rules related to the immune defense of the body.

So, summing up, it is worth recalling that in the treatment of this disease there is a direct struggle with the symptoms that manifested themselves in glandular fever. As well as the treatment of affected organs that were affected by the infection. Do not forget about the ways of transmission of infection and stay away from people who have an acute form of the disease, if these are your loved ones, you must wear a mask and provide separate dishes for the patient.

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