Mononucleosis Epstein Barr Virus

Epstein-Barr Virus – EBV (Mononucleosis)
A contagious disease, infectious mononucleosis is mostly caused by the Epstein-Barr virus (EBV) (Centers for Disease Control and Prevention – CDC, 2018). It is, however, important to note that in most cases, an infection with EBV does not necessarily progress to mononucleosis. Essentially, EBV infections are commonplace and may not present any symptoms, particularly during the childhood early adulthood phases. However, as CDC (2018) points out, “at least one out of four teenagers and young adults who get infected with EBV will develop infectious mononucleosis.” Most infections on this front spread as a consequence of close contact with an individual who is already infected, i.e. via sharing of cutlery or kissing.
Some of the more common symptoms of EBV infection include, but they are not limited to, “sore throat, cervical lymph node enlargement, fatigue and fever most often seen in adolescents and young adults and lasting several weeks” (Dunmire, Hogquist, and Balfour, 2015). Other symptoms may include rash, swollen spleen or liver (or both in some instances), and body pain as well as headaches (CDC, 2018). As CDC (2018) further points out, most mononucleosis symptoms become apparent within four to six weeks of EBV infection.
According to CDC (2018), mononucleosis is in some instances diagnosed on the basis of symptoms alone. It is, however, important to note that in some instances, the symptoms presented could be signs of many other diseases. In most cases, a positive heterophile test, as Dunmire, Hogquist, and Balfour (2015) point out, is all that may be needed for diagnostic purposes. It should, however, be noted that due to lack of specificity of heterophile antibodies, as well as failure of the same to develop in some persons, Dunmire, Hogquist, and Balfour (2015) are of the opinion that “EBV-specific antibody profiles are the best choice for staging EBV infection.”
There is need to consider group A beta-hemolytic streptococci virus and taxoplasma gondii in infectious mononucleosis’ differential diagnosis. This is more so the case given that as Bravender (2010) points out, “approximately 10% of those with IM will not be acutely infected with EBV.” When it comes to group A beta-hemolytic streptococci virus, it is important to note that it is in most cases clinically indistinguishable from EBV. Towards this end, there is need for group A beta-hemolytic streptococci virus throat culture as a differentiating test. As Buttaro, Tybulski, Polgar-Bailey, and Sandberg-Cook (2012) point out, “in individuals with a negative throat culture for group A beta-hemolytic streptococci, symptoms that persist for more than a week are highly suggestive of acute IM” (1273). When it comes to toxoplasma gondii, generalized adenopathy, as Cunha (2017) points out, is not a feature. This contrasts taxoplasma gondii with EBV. Also, in addition to those with taxoplasma gondii exhibiting no (or a little) fever, pharyngitis, and fatigue, “asymmetrical lymphadenopathy limited to an isolated lymph node group” is highly characteristic of taxoplasma gondii (Cunha, 2017).
It should be noted that at present, infectious mononucleosis has no specific treatment (Dunmire, Hogquist, and Balfour, 2015). However, as CDC (2018) points out, “based on the severity of the symptoms, a healthcare provider may recommend treatment of specific organ systems affected by infectious mononucleosis.” In that regard, therefore, an enlarged spleen or throat swelling could be treated using corticosteroids. The most effective way for persons to protect themselves from infectious mononucleosis is by way of avoiding intimate contact (i.e. kissing, sharing of personal effects like toothbrush, spoons, cups, etc.) with persons infected with the same (CDC, 2018). Symptoms of the disease could be relieved by using fever and pain medications, getting adequate rest, and staying hydrated via the intake of a lot of fluids.

References
Bravender, T. (2010). Epstein-Barr Virus, Cytomegalovirus, and Infectious Mononucleosis. Adolescent Medicine: State of the Art Reviews, 21(2), 251–264.
Buttaro, T.M., Tybulski, J., Polgar-Bailey, P. & Sandberg-Cook, J. (2012). Primary Care - E-Book: A Collaborative Practice (4th ed.). Missouri: Elsevier Health Sciences.
Centers for Disease Control and Prevention – CDC (2018). About Infectious Mononucleosis. Retrieved from https://www.cdc.gov/epstein-barr/about-mono.html
Cunha, B. (2017). Epstein-Barr Virus (EBV) Infectious Mononucleosis (Mono) Differential Diagnoses. Retrieved from https://emedicine.medscape.com/article/222040-differential
Dunmire, S.K., Hogquist, K.A. & Balfour, H.H. (2015). Infectious Mononucleosis. Curr Top Microbiol Immunol, 390(8), 211-240.