Infectious Mononucleosis (mono)
Epstein- Barr Virus is the culprit causing infectious mononucleosis (hence "mono"). People with the disease usually have a fever, fatigue, pus on their tonsils, swollen neck glands (and sometimes really big) and a big spleen and liver. This disease is a great example of pus on tonsils that is not strep. The disease can have a red all-over rash, especially if we treat the pus on the tonsils as strep and give you amoxicillin without doing the strep test. (Read that: no antibiotics for strep unless we test and the test is positive.) More rarely, the disease can have blood count changes, swollen testes, heart infections and airway obstruction.
Humans are the only creatures who get this disease. It is passes through close personal contact. The disease can occur in all age groups, but is most noticeable in adolescents and therefore got the name by which is more frequently known, the "kissing disease." It doesn't occur at any particular time of the year, and you can have the disease without any symptoms whatsoever. When you have it, we don't really know how long you are infectious, but you usually feel tired and lousy for a couple of weeks. And when you have close personal contact with someone with the disease, it can take anywhere from 30 to 50 days before you show symptoms, if you do.
We can do a couple of tests for it, all of which are blood tests. Some are done quickly "the monospot" but can have unreliable results. The more reliable results take longer to come back. Treatment consists of Popsicles, acetaminophen, ibuprofen, rest and fluids. There really is no prescription treatment.
So why would we test for it? Well, you feel lousy for a couple of weeks, so we can give you a heads up as to that fact. And, probably more importantly, the spleen can get pretty big when you have mono.
The spleen is an organ on the left side of your abdomen that functions to remove old and damaged red blood cells and such. It's got the consistency of the cranberries that nobody in my family eats on Thanksgiving. Those cranberries are usually protected by the rib cage, but in mono, the spleen gets big, and extends downward toward your pelvis, and then has no protection. That means that if you get hit in the enlarged spleen, the cranberries can rupture. And splenic rupture is bad. Therefore, we keep you out of gym class and soccer and football and whatever other contact sports you participate in until your spleen isn't big anymore, usually about 3 weeks.