Infectious Mononucleosis

IM is an acute mononuclear-phagocyte proliferative EBV disease, self-limited. Irregular fever, lymphadenopathy, sore throat; lymphocytosis with atypical lymphocytes; positive heterophile agglutination and EBV antibodies.

Common Symptoms

Abnormal LFTs; papulomacular rash; nasal congestion; multiple petechiae; hypersplenism; nausea; small palatal petechiae

Causes and Pathogenesis

(1) Etiology: Sprunt/Evans 1920; Paul/Bunnell 1932 heterophile antibody; Epstein/Achong/Barr 1964 from Burkitt lymphoma. EBV (Herpesviridae/HHV-4), dsDNA; nucleoid/capsid/capsomere/envelope; replicates in African lymphoma/IM blood/leukemia/healthy brain cells. Six antigens: VCA, MA, EA (D/R), S (complement-fixing), NA, LYDMA. (2) Pathogenesis: pharyngeal/salivary epithelial replication → viremia → lymphoid tissues. B cells have CD21 receptor; 1% B cells infected acutely → 1/1,000,000 in convalescence; memory B cells long-term reservoir. Atypical lymphocytes = T cells; CD4 down, CD8 up. NK/CTL important early; HLA-restricted CTL later.

Treatment

Drug therapy, supportive, symptomatic

Preventive Measures

No effective prevention; respiratory isolation/boil secretions debated; blood donors defer ≥6 months after onset.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.