What are the symptoms of mononucleosis (mono)?
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Symptoms of Mononucleosis (Mono)
Common Symptoms of Mononucleosis
Mononucleosis, often referred to as "mono" or the "kissing disease," is primarily caused by the Epstein-Barr virus (EBV). It is most prevalent among adolescents and young adults aged 15 to 24 years . The hallmark symptoms of mono include a triad of fever, tonsillar pharyngitis, and lymphadenopathy. These symptoms are often accompanied by profound fatigue, which can persist for several months .
Additional Symptoms and Complications
Fatigue and Malaise
Fatigue is one of the most debilitating symptoms of mono, often lasting for weeks or even months . Patients frequently report feeling extremely tired and may experience diurnal somnolence and depression during the post-acute phase.
Lymphadenopathy
Generalized lymphadenopathy, particularly in the cervical region, is a common manifestation . This swelling of the lymph nodes can be painful and is often accompanied by a sore throat .
Hepatosplenomegaly
Approximately 50% of patients with mono experience splenomegaly (enlarged spleen), and about 10% have hepatomegaly (enlarged liver) . These conditions necessitate caution, as they increase the risk of splenic rupture, a potentially life-threatening complication.
Skin Rash
A skin rash, typically erythematous and maculopapular, occurs in about 10 to 45% of cases. This rash is often widely scattered and can be mistaken for other viral exanthems.
Other Symptoms
Other notable symptoms include night sweats, painful neck swelling, and periorbital or palpebral edema, which occurs in about one-third of patients . Some patients may also experience palatal petechiae, posterior cervical or auricular adenopathy, and inguinal adenopathy.
Rare and Severe Manifestations
Retinal Changes and Vision Issues
In rare cases, mono can present with retinal changes and acute reduction of vision, complicating the diagnosis and potentially leading to misdiagnosis as other severe conditions like sepsis or hepatitis.
Chronic Fatigue Syndrome
Mono is a known risk factor for chronic fatigue syndrome, a condition characterized by prolonged and severe fatigue that can last for months or even years.
Splenic Rupture
Although rare, spontaneous splenic rupture occurs in 0.1 to 0.5% of patients and is a serious, life-threatening complication. Patients are advised to avoid contact sports or strenuous activities for at least eight weeks or until splenomegaly resolves .
Conclusion
Mononucleosis presents with a variety of symptoms, ranging from the common triad of fever, pharyngitis, and lymphadenopathy to more severe and rare manifestations like retinal changes and splenic rupture. Understanding these symptoms is crucial for prompt diagnosis and effective management, ensuring that patients receive appropriate care and avoid unnecessary complications.
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