“Infectious 

Mononucleosis”
(Mono; 
Glandular Fever ;
“Kissing Disease”)

Presented By :
Samira
Defination :
Infectious mononucleosis (IM, mono) is
also known as glandular fever.
It is an infection usually caused by the
Epstein–Barr virus (EBV) or HHV-4.
Most people are infected by the virus as
children, when the disease produces few
or no symptoms.
It Is Also Called “Kissing Disease”
• Infectious Mononucleosis is a debilitating EBV
Infection Of B Lymphocytes Characterized By
Fatigue , Malaise , Lymphadenopathy , Fever
and other symptoms that persist for prolonged
periods ; it occurs primarily in young adults.
• When the initial infection is acquired during
early childhood, it is mild and usually
subclinical.
• In contrast, when acquired in adolescence or
young adulthood, it frequently leads to the
development of IM.
 Transmission :
The virus that
causes mono is transmitted
through saliva, so you can
get it through kissing, but
you can also be exposed
through a cough or sneeze,
or by sharing a glass or food
utensils with someone who
has mono.
However, mononucleosis
isn't as contagious as
some infections, such as the
common cold.
Clinical Features :
IM can be a severe, debilitating
condition characterized by:
• lymphadenopathy,
• malaise,
• pharyngitis,
• fatigue,
• fever,
• hyperplastic tonsils,
• thrombocytopenia, and
splenomegaly.
• Intraorally, patients often
• The condition generally persists for 4 to 6
weeks; however, lymphadenopathy and
the minor degrees of fatigue and malaise
persist for several months.
Complications :
Complication are uncommon at any age but
most frequently arise in children .
Possible significant complications include:
• Splenic Rupture
• Thrombocytopenia
• Auto Immune Hemolytic Anemia
• Aplastic Anemia
• Neurologic Problems
• Myocarditis
• Hemophagyoctic Lymphohistiocytosis
HISTOPATHOLOGY :
Tissue from either the tonsils or enlarged
lymph nodes exhibits:
• germinal hyperplasia
• large, abnormal, non neoplastic T
lymphocytes.
• The aberrant lymphocytes are basophilic
with a vacuolated cytoplasm and large,
kidney-shaped nuclei.
DIAGNOSIS:
Diagnosis is based on:
• a combination of clinical findings,
• a positive heterophil antibody test,
• and Epstein-Barr virus capsid antigens
(EBVCA).
• Cultures for EBV are not available on a
routine diagnostic basis.
• The Paul Bunnell test and rapid slide agglutination (Monospot) assay are
frequently used methods for detection of heterophil antibodies
• The classic serologic finding in EBV is
the presence of the Paul-Bunnell heterophil antibody; a
rapid test for these antibodies is available and inexpensive.
• More than 90% of infected young adults have positive
findings for the heterophil anti body, but infected children
younger than age 4 frequenty have negative results.
• Indirect immunofluorescent testing to detect EBV-specific
antibodies should be used in those suspected of having
an EBV infection but whose findings were negative on the
Paul-Bunnell test.
• Enzyme-linked immunosorbent assays (ELISA) and recombinant DNA-derived
antigens may soon replace the indirect immunofluorescent test .
TREATMENT:
• Acyclovir is of little help in relieving
symptoms and in controlling the course
of diseases caused by EBV.
• Rest and analgesia are the primary
supportive measures used by clinicians.
• Restricting periods of physical exertion
is
important to reduce the possibility of
splenic rupture. It is not
necessary to isolate patients with IM.