Infectious Mononucleosis and EBV Management

Diagnosis and Confirmation of EBV Infection

• Diagnosis relies on clinical presentation.
• Monospot blood test is a common, rapid diagnostic tool.
• Complete blood count (CBC) often shows increased bands, neutrophils, lymphocytes, reactive lymphocytes, and thrombocytopenia.

Treatment and Management of Infectious Mononucleosis (Mono)

• Treatment primarily focuses on managing symptoms.
• Analgesics are used to alleviate fever and muscle pain (myalgias).
• Short-term oral glucocorticoids might be beneficial for severely enlarged tonsils or airway obstruction concerns.
• Antivirals are generally unnecessary, as symptoms stem from the immune response rather than viral replication; however they may be considered in cases of chronic EBV.
• Contact sports should be avoided to prevent splenic rupture, resuming only after splenomegaly resolves (typically within weeks).
• Fatigue is a common symptom that may persist for 2-6 months.

Complications of EBV Infection

• Splenic rupture is a potential complication.
• EBV infection increases the risk of B-cell lymphomas (Burkitt lymphoma, classical Hodgkin lymphoma) and certain cancers (gastric and nasopharyngeal).
• Hemolytic anemia, thrombocytopenia, meningitis, myelitis, and Guillain-Barré syndrome are possible complications of EBV and CMV co-infections.
• Reactivation can occur in immunosuppressed states.

Cytomegalovirus (CMV) Infection

• Prior CMV infection leads to latent viral persistence in the body.
• Latent CMV resides in all solid organs and can reactivate following transplantation and subsequent immunosuppressive therapy.