Infectious mononucleosis at the united states military academy. Some data derived in the united kingdom suggest that infectious mononucleosis im cases may be occurring later in life with increasing severity, requiring hospitalization. Infectious mononucleosis im is characterized by a triad of fever, tonsillar pharyngitis, and lymphadenopathy. An unexpected finding was the large number of young children, less than 4 years old, with this disease. Infectious mononucleosis presenting as upper airway. In consideration of payment of the applicable subscription fee, the aap is willing to. Complete blood count cbc may be done to help confirm the diagnosis of mono and rule out other infections or complications of mono. Pediatric annals infectious mononucleosis im is a familiar disorder to physicians who treat adolescents. Airway obstruction in children with infectious mononucleosis. Convulsion as a presenting sign of infectious mononucleosis. It manifests typically as fever, pharyngitis with petechiae, exudative pharyngitis, lymphadenopathy, hepatosplenomegaly, and atypical lymphocytosis. Pediatric infectious mononucleosis childrens national. Pediatric airway compromise, though a well documented complication of infectious mononucleosis, is often missed in differential diagnosis of severe stridor1,4. Dexamethasone for the treatment of infectious mononucleosis.
Chief, pediatric infectious diseases university of texas health science center san antonio, tx and by charles t. Most people become infected with ebv at some point in their lives. Physical examination is significant for splenomegaly, tonsillar exudate, and posterior auricular lymphadenopathy. Infectious mononucleosis 4 to 7 week incubation acute selflimiting infection of the re system enlarged lymph nodes in the neck. High wbc, over 20% atypical reactive lymphocytes also known as downey cells. Overall, mononucleosis is only slightly contagious from contacts. The epsteinbarr virus ebv may cause infectious mononucleosis in adolescents and young adults. Children with infectious mononucleosis, in particular the very young, tended to have more rashes. We have vast experience diagnosing and caring for common illnesses like infectious mononucleosis. Pharyngeal pain from infectious mononucleosis im can be severe and may persist for up to 14 days. Neurologic manifestations of infectious mononucleosis in the adult are well documented.
Incidence of rash after amoxicillin treatment in children with infectious mononucleosis whats known on this subject. Like all herpesviruses, ebv stays within the body once a person is infected. Antibioticsinduced rash in epsteinbarr virus acute infectious mononucleosis, especially the aminopenicillinsinduced type, was. Epsteinbarr virus infectious mononucleosis in children i. This condition generally is a benign, selflimited illness in healthy persons. Infectious mononucleosis in children is a polyethological disease caused by viruses from the herpesviridae family, which occurs with fever, angina, polyadenitis, enlargement of the liver and spleen, and the appearance of atypical mononuclear cells in the peripheral blood. Mononucleosis infectious mononucleosis n siena pediatrics. Infectious mononucleosis mono is a common acute infectious disease usually found in individuals between the ages of 5 and 30.
Infectious mononucleosis mono is an infection that causes sore throat, fever, swollen glands, and tiredness or fatigue. Infectious mononucleosis is the most common presentation of epsteinbarr virus ebv infection. It is most often caused by infection with the epsteinbarr virus ebv. Incidence of rash after amoxicillin treatment in children with infectious mononucleosis article pdf available in pediatrics 15 april 20 with 934 reads how we measure reads. The disease occurs worldwide with no seasonal predilection.
I nfectious mononucleosis is a clinical syndrome caused by epsteinbarr virus ebv that is particularly common in adolescents and children. Infectious mononucleosis im or mononucleosis syn drome is. However, even after the symptoms of infectious mononucleosis have disappeared, the ebv will remain dormant in the throat and blood cells during that persons lifetime. Infectious mononucleosis and renal failure pediatric focus. We now know that the characteristic atypical lymphocytes, carefully described morphologically by downey and mckinlay, 2. Infectious mononucleosis is the most common presentation and was described in the late 19th century by filatov and pfeiffer and was initially called drusenfieber glandular fever. Large studies of infectious mononucleosis are now decades old, but traditionally, the peak incidence of infection has been described in the 15 to 24year age range. Most people are infected by the virus as children, when the disease produces few or no symptoms. Pediatric mononucleosis and epsteinbarr virus infection. It is caused by the epsteinbarr virus ebv, which is a member of the herpes virus family. Epsteinbarr virus infections red book 2015 red book. It is most commonly caused by the epsteinbarr virus ebv. Nonoperative management of sponta neous splenic rupture in infectious mononucleosis. Epsteinbarr virus infectious mononucleosis in children.
Infectious mononucleosis is a common, usually mild illness. Ampicillin rash, a phenomenon unique to patients with epsteinbarr virus acute infectious mononucleosis aim treated with ampicillin, was first reported in the 1960s. The virus can reactivate periodically, however, usually without symptoms. A 14yearold girl with infectious mononucleosis and secondary immunosuppression had severe dyspnea and cough, spiking fever, rales, and diffuse bilateral pulmonary infiltrates. Clinical presentation of the disease is characterized by fever, tonsillopharyngitis, lymphadenopathy, and. Epsteinbarr virusassociated infectious mononucleosis causing. Pmc free article hallee tj, evans as, niederman jc, brooks cm, voegtly j h. Infectious mononucleosis is sometimes called mono or the kissing disease. Treatment for infectious mononucleosis is generally supportive. Infectious mononucleosis complicated by severe mycoplasma. Division of disease control what do i need to know.
Infectious mononucleosis is transmitted by exposure to saliva, so it can be spread by kissing, by sharing glasses or cutlery, and by droplets spread by coughing. Frequently, symptoms include sore throat, malaise, fevers, lymphadenopathy, and abdominal pain. Incidence of rash after amoxicillin treatment in children. After the fever is gone, the virus is still carried in the saliva for up to 6 months, but in small amounts. The etiologic agent for infectious mononucleosis is epsteinbarr virus, although a mononucleosislike syndrome can be caused by other viral agents, most notably cytomegalovirus. Acute kidney injury complicated epsteinbarr virus infection in infancy. Infectious mononucleosis is the name coined by sprunt and evans in 1920 1 for an acute infectious disease consisting of fever, cervical lymphadenopathy and pharyngitis accompanied by atypical large peripheral blood lymphocytes. Acute infectious mononucleosis presents with a history of 12 weeks of fatigue and malaise. The spectrum of diseases is wide, ranging from asymptomatic to fatal infection.
In the united states, interest in ebv infection focusses on the typical clinical syndrome infectious mononucleosis and on its emerging relationship with an increasing number of tumors, noted for the most part in immunocompromised patients. In consideration of payment of the applicable subscription fee, the aap is willing to provide access to the materials to you and, if applicable, your. Infectious mononucleosis was recognized as a unique disease in the 1880s by nil filatov, a russian pediatrician, who called the syndrome. The american academy of pediatrics aap hosts the website and related materials on its servers and makes them available via the internet to subscribers for noncommercial research and education purposes and for use in providing healthcare services. Epsteinebarr virusassociated infectious mononucleosis causing upper airway obstruction in a child with a history of adenoid hypertrophy. Infectious mononucleosis im is a common childhoodadolescent illness. Early signs or symptoms of mono can be vague, such as headache, chills, easy fatigability, fever and sore throat. It was initially described as drusenfieber or glandular fever in 1889, but the term infectious mononucleosis was later used in 1920 to describe six college students with a febrile illness characterized by absolute lymphocytosis and atypical mononuclear cells in the blood 2,3. Infectious mononucleosis im was first described in the russian medical literature in 1885. Mononucleosis epsteinbarr virus infection, mono what is infectious mononucleosis.
It is caused most often by the epsteinbarr virus ebv, which is in the herpesvirus family of organisms. The pulmonary disease progressed rapidly, necessitating empiric trials of. Sore throat, fever, rash malaise, lethargy, extreme tiredness liver and spleen involvement and enlargement hematology. Pdf incidence of rash after amoxicillin treatment in. Infectious mononucleosis is a clinical entity characterized by pharyngitis, cervical lymph node enlargement, fatigue and fever. Infectious mononucleosis, also known as kissing disease, mononucleosis, or, sometimes, just mono, is an illness characterized by many complaints, but primarily by fever, fatigue, tiredness, enlarged lymph nodes lymphadenopathy, and a sore throat. Mononucleosischild care and schools patient education. Infectious mononucleosis, also known as mono, is a viral disease that affects certain blood cells.
Atypical manifestations of epsteinbarr virus in children core. Between 1976 and 1982, 1 children aged 6 months to 16 years with documented epsteinbarr virusinduced infectious mononucleosis were studied prospectively, and in most instances serially. It is recognized most frequently in adolescents and young adults from developed countries for reasons that are not completely understood. Infectious mononucleosis, also known as mononucleosis, mono, or glandular fever, is characterized by swollen lymph glands and chronic fatigue.
Clinical and laboratory characteristics of infectious mononucleosis. The most common manifestation of primary infection with this organism is acute infectious mononucleosis, a selflimited clinical syndrome that most frequently affects adolescents and young adults. Most cases occur sporadically and outbreaks are rare. Serological response of the ebv antibodies in pediatric cases of infectious mononucleosis and in their contacts. Severe complications from infectious mononucleosis after. We sought to establish the current incidence of rash associated with antibiotic. The classic physical findings of infectious mononucleosis include fever, lymphadenopathy, pharyngitis, and splenomegaly. Epsteinbarr virus ebv, or human herpesvirus 4, is a gammaherpesvirus that infects more than 95% of the worlds population. Infectious mononucleosis american academy of pediatrics. Severe complications have been reported such as splenic rupture, acute upper airway obstruction, hepatitis, acute renal failure, and hematological and neurological complications.
Infectious mononucleosis is an acute lymphoproliferative disorder caused by the epsteinbarr virus ebv and seen most commonly in children and young adults. Epsteinbarr virus, mononucleosis, pediatric infections. Pdf infectious mononucleosis is a clinical entity characterized by pharyngitis, cervical lymph node enlargement, fatigue and fever, which. In young adults, the disease often results in fever, sore throat, enlarged lymph nodes in the neck, and tiredness. Infectious mononucleosis im, mono, also known as glandular fever, is an infection usually caused by the epsteinbarr virus ebv. Infectious mononucleosis im is a disease common among adolescents in the united states. Classic physical findings include fever, splenomegaly, pharyngitis, and lymphadenopathy. Mononucleosis tests including the monospot test and ebv antibody test are blood tests. The pediatric specialists at the division of adolescent medicine at boston children s hospital provide comprehensive primary care to patients ages 10 to 23. In this article, the term infectious mononucleosis refers to the disease caused by primary ebv infection, although other agents can cause infectious mononucleosis like disorders that are clinically similar to the ebvassociated disease.
Since ebv is spread by saliva, close contact, such as kissing or young children playing together, spreads the disease. Department of hematology, childrens hospital of shanghai, shanghai jiao tong university, shanghai, china. It is possible for the monospot test to come back negative early in the course of the infections false negative. Infectious mononucleosis is most contagious while your child has a fever.
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