Mononucleosis

Alternative Names

Symptoms

• Fever
• Sore throat
• Swollen lymph nodes, especially in the neck and armpit
• General discomfort, uneasiness, or ill feeling
• Drowsiness
• Loss of appetite
• Muscle aches or stiffness
• Swollen spleen
• Rash

Less frequently occurring symptoms include:

• Jaundice (yellow cast to skin)
• Headache
• Neck stiffness
• Sensitivity to light
• Cough
• Shortness of breath
• Chest pain
• Rapid heart rate
• Fatigue
• Nosebleed
• Hives

Exams and Tests

During a physical examination, the doctor may find swollen lymph nodes in the front and back of the neck, as well as swollen tonsils with the whitish covering. The doctor might also find a swollen liver or swollen spleen when pushing on your belly. There may be a skin rash.

Laboratory findings often include a higher-than-normal white blood cell count, and the characteristic finding of atypical lymphocytes -- unusual-appearing white blood cells that are seen when blood is examined under a microscope. Abnormal liver function tests are also characteristic.

Common tests for EBV include:

• A monospot test (positive for infectious mononucleosis)
• Epstein-Barr virus antigen by immunofluorescence (positive for EBV)
• Epstein-Barr virus antibody titers to help distinguish acute infection from past infection with EBV

References

Hoffman, R., ed. Hematology: Basic Principles and Practice. 4th ed. New York, NY: Churchill Livingstone, 2005.

Gershon, AA, Hotez, PJ, and Katz, SL, eds. Krugman’s Infectious Diseases of Children. 11th ed. St. Louis, Mo: Mosby; 2004.

Noble J, ed. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001.