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Infectious mononucleosis (CMV)

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Illustrations

Mononucleosis, photomicrograph of cells
Mononucleosis, photomicrograph of cells
Mononucleosis, photomicrograph of cells
Mononucleosis, photomicrograph of cells
Infectious Mononucleosis #3
Infectious Mononucleosis #3
Infectious mononucleosis
Infectious mononucleosis
Mononucleosis, photomicrograph of cell
Mononucleosis, photomicrograph of cell
Mononucleosis - mouth
Mononucleosis - mouth
Antibodies
Antibodies

Alternative names    Return to top

CMV Mononucleosis; Acute acquired cytomegalovirus infection; Cytomegalovirus (CMV)

Definition    Return to top

Infectious mononucleosis is an acute viral infection that can cause high fever, sore throat, and swollen lymph glands, especially in the neck. Unlike the more common form of mononucleosis, caused by the Epstein-Barr virus, this type is caused by cytomegalovirus (CMV).

Causes, incidence, and risk factors    Return to top

Infectious mononucleosis can be caused by several different viruses and a few types of bacteria. Less commonly, it is caused by parasites.

The most commmon causes are the Epstein-Barr virus (EBV) and cytomegalovirus (CMV), both members of the herpesvirus family. The symptoms of infection, including sore throat, occur less commonly with CMV than with EBV.

The infection is transmitted by saliva, sexual contact, respiratory droplets, and blood transfusions. While the peak incidence occurs in 15- to 17-year-olds, the infection may occur at any age, most often between the ages of 10 and 35.

Abnormal or atypical lymphocytes (white blood cells) are seen in the peripheral blood, and may persist for 2 to 8 weeks. Abnormalities of liver function are also characteristic. Risk factors other than age are not known. The vast majority of people are exposed to CMV early in life and do not realize it because they have no symptoms.

Symptoms    Return to top

Less common symptoms include:

Signs and tests    Return to top

A physical examination reveals an enlarged liver or an enlarged spleen. The liver and spleen may be tender when they are gently pressed (palpated). There may be a skin rash.

Treatment    Return to top

Most patients recover within 4 to 6 weeks without medication. There is no specific treatment available. Antiviral medications do not help. Rest is needed, sometimes for a month or longer to regain full activity levels. Relief of symptoms is provided with analgesics, and warm salt water gargles for sore throat.

Expectations (prognosis)    Return to top

Fever usually resolves in 10 days, and swollen lymph glands and spleen return to normal in 4 weeks. Fatigue may linger for 2 to 3 months.

Complications    Return to top

Calling your health care provider    Return to top

Call for an appointment with your health care provider if symptoms indicate mononucleosis.

Go to the emergency room or call the local emergency number (such as 911) if sharp, sudden pain in left upper abdomen occurs. This could indicate a ruptured spleen, which requires emergency surgery.

Prevention    Return to top

Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person. Because the infection is probably spread by saliva or sexual contact, kissing and sexual contact with an infected person should be avoided.

However, the vast majority of people are exposed to CMV early in life without suffering any symptoms, so it is very difficult to control infection and spread of CMV.

Update Date: 7/12/2004

Updated by: Daniel Levy, M.D., Ph.D., Infectious Diseases, Greater Baltimore Medical Center, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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