Epstein-Barr Virus (EBV) Infectious Mononucleosis (Mono) Questions & Answers

Updated: Apr 21, 2021
  • Author: Kartika Shetty, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Questions & Answers

Overview

When was Epstein-Barr virus (EBV) infectious mononucleosis (mono) first described and how was it characterized?

How is Epstein-Barr virus (EBV) transmitted (the virus that causes infectious mononucleosis [mono])?

What is the pathophysiology of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What is the role of the T-lymphocyte cellular response in determining the clinical expression of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How does the physiologic response to the Epstein-Barr virus (EBV) cause the symptoms of infectious mononucleosis (mono)?

How common is Epstein-Barr virus (EBV) infectious mononucleosis (mono) in the US?

How is fatigue characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which characteristics or complications of the virus are associated with severe illness or death?

What are the age-related demographics of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Presentation

Do all people with Epstein-Barr virus (EBV) infectious mononucleosis (mono) have symptoms?

What is the incubation period of Epstein-Barr virus (EBV) infectious mononucleosis (mono) and what are the common presenting symptoms?

Which symptoms are associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What is the predisposing risk factor associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Where in the body does Epstein-Barr virus (EBV) persist in infectious mononucleosis (mono)?

Which comorbidities are associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono) in patients with congenital immunodeficiencies?

Which comorbidities are associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono) in patients with acquired immunodeficiencies?

Which physical findings are associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

DDX

What is the presentation of pharyngitis in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which conditions in addition to Epstein-Barr virus (EBV) infectious mononucleosis (mono) are associated with palatal petechiae?

What does uvular edema indicate in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is lymphadenopathy distinguished from Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is a finding of leukocytosis used to confirm or exclude Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is lymphocytosis characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is thrombocytopenia characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How are serum transaminases characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono), and which mononucleosislike illnesses may be indicated by other findings?

How is the erythrocyte sedimentation rate (ESR) measurement used in the diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is the rash associated with Epstein-Barr virus (EBV) infectious mononucleosis (mono) characterized?

How is the external eye involvement of Epstein-Barr virus (EBV) infectious mononucleosis (mono) characterized, and what other findings of the periorbital area suggest a different diagnosis?

How common is splenic rupture in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What are the diagnostic considerations for meningoencephalitis in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What is the role of fatigue in the diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is fatigue characterized in Epstein-Barr virus (EBV) infectious mononucleosis (mono) and what does chronic fatigue suggest?

What is is chronic infectious mononucleosis (mono) and how is it differentiated from chronic fatigue syndrome (CFS)?

Workup

Which antibodies does an Epstein-Barr virus (EBV) mononucleosis (mono) infection induce?

What is the sensitivity and specificity of the heterophile antibody test in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is the heterophile antibody test used to differentiate heterophile-negative infectious mononucleosis (mono) and Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is testing for Epstein-Barr virus (EBV)-specific antibodies used in the workup of infectious mononucleosis (mono)?

Which nonspecific tests are included in the workup for Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which lab studies are specific for Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which other tests may be indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When are imaging studies indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When is an EEG indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When is a bone marrow or lymph node biopsy indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

When is a lumbar puncture indicated in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What do histologic findings demonstrate in the workup of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Treatment

How are patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) monitored and when are steroids used for treatment?

When is surgery indicated in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Which consultations may be necessary in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What type of diet is appropriate in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What level of activity is encouraged in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Medications

Is antiviral therapy available in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Is antiviral therapy available for immunocompromised patients with Epstein-Barr virus (EBV) lymphoproliferative disease?

When are corticosteroids indicated in the treatment of Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How is group A streptococcal (GAS) infection treated in patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

Follow-up

How are patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) monitored?

What do patients need to know about fatigue and Epstein-Barr virus (EBV) infectious mononucleosis (mono) titers?

What does extreme tonsillar enlargement indicate in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

How can patients avoid contracting Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What are complications associated with infectious mononucleosis (mono)?

What is the prognosis of splenic rupture in Epstein-Barr virus (EBV) infectious mononucleosis (mono)?

What do patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) need to know about physical activity restrictions?

How can patients with Epstein-Barr virus (EBV) infectious mononucleosis (mono) prevent spreading the disease to others?

What patient education resources are available for Epstein-Barr virus (EBV) infectious mononucleosis (mono)?