Infectious mononucleosis (IMS) is a viral infection caused by the Epstein-Barr Virus (EBV). Common layman terms for IMS include "glandular fever" and "kissing disease". EBV is a common virus and most people would have been exposed to it at some point in their lives. It is often spread through coughing, sneezing and sharing of food/drinks with an infected person.
(Above image shows the virus under microscope)
The symptoms of IMS include:
- Severe sore throat
- Painful swallowing
- Fever
- Lethargy
- Body aches
The diagnosis of IMS is mainly from clinical examination. Often, the tonsils of a patient with IMS would be swollen, red and may have a white patch coating it.
(Above image shows swollen tonsils with white spots)
This is a classic appearance of IMS although not all patients will have such clinical findings. Other signs include fever and swollen lymph nodes in the neck. Blood tests are often performed to look at the severity of the infection (from the degree of raised total white count) and liver enzymes (due to risk of liver inflammation). A blood test in patients with IMS may show a raised lymphocyte count (a subtype of white cell) and the presence of atypical lymphocytes. However, to confirm the presence of EBV infection, specific blood test looking at antibodies against EBV is required.
As IMS is a viral infection, the treatment is targeted mainly at relieving the symptoms. Your immune system will take care of the viral infection. Adequate rest, hydration, pain relievers, mouth gargle and lozenges are often all that is required for most sufferers. Sometimes, there may be concurrent bacterial tonsillitis (often called "Strep Throat"). In such an instance, antibiotics may be prescribed. Although rare, IMS can cause complications in other organs such as
- Liver inflammation (hepatitis)
- Inflammation of the heart (myocarditis) and
- Spleen enlargement
Because of a small risk of rupture of the spleen, it is advisable for patients with IMS to avoid contact sport for at least 1 month. The swollen tonsils may take about 1-2 weeks to subside while the swollen glands typically take several weeks to a month or two to completely resolve or reduce significantly in size. It is best to discuss with your doctor if you are concerned about persistent swollen lymph nodes or tonsils.
