Mononucleosis or glandular fever is an infection caused by a virus Epstein-Barr (EBV). The spread of the EBV virus occurs through body fluids, especially saliva. Mononucleosis can also be caused by other types of viruses, such as cytomegalovirus (CMV), toxoplasmosis, HIV, rubella, hepatitis (A, B, or C), and adenovirus.
Mononucleosis is not a serious disease. However, if left unchecked, the symptoms that appear will get worse and can hinder the sufferer from carrying out daily activities for a long period of time. Mononucleosis can affect anyone, from infants to the elderly. However, adolescents are the group most susceptible to this disease.
Causes of Mononucleosis
The main cause of mononucleosis is a virus Epstein-Barr (EBV). The spread of this virus occurs through direct contact with saliva or other body fluids, such as blood or sperm, from an infected person. Some activities that can increase the risk of spreading mononucleosis are:
- Kissing
- Sharing a toothbrush
- Sharing eating or drinking utensils without washing them first
- Cough or sneeze
- Sexual intercourse
- Organ transplant.
When saliva infected with the EBV virus enters the human body, this virus will begin to infect cells on the surface of the throat wall. The body will naturally secrete white blood cells, namely B lymphocytes, to fight the infection. B lymphocyte cells containing the EBV virus will be captured by the lymph node system scattered in various parts of the body, so that the virus then spreads widely in the human body.
There are several groups of people who are prone to mononucleosis, namely:
- Young adults aged 15-30 years, because they often have direct contact with many people and have the highest social activities
- Doctors and nurses
- People taking immunosuppressive drugs.
Symptoms of Mononucleosis
The EBV virus that enters the body will remain for approximately two months before finally causing symptoms. Symptoms that appear are almost similar to other viral infections, such as the flu, so they are difficult to identify. Some of the most common symptoms are:
- Fever
- Sore throat
- Swollen lymph nodes in the neck, under the armpits, and groin.
Some other symptoms that can appear are:
- Headache
- Body feels weak and easily tired
- Shivering
- Muscle ache
- Decreased appetite
- Swollen and painful eyes
- Dark red or purple spots appear on the roof of the mouth.
Mononucleosis Diagnosis
Your doctor will diagnose mononucleosis through a physical exam to look for signs you're experiencing, such as:
- Swollen tonsils
- Swollen lymph nodes in the neck
- Enlargement of the spleen and liver.
The doctor will also advise the patient to undergo laboratory tests through a blood sample. The types of blood tests that will be done are:
- Complete blood count test.Through a complete blood count, doctors can detect several signs that indicate a patient is infected with mononucleosis, namely:
- An increase in the number of white blood cells (lymphocytes) (lymphocytosis)
- Lymphocytes look abnormal
- Decreased platelet or platelet count
- Liver disfunction.
- Monospot test (heterophil antibody test), to detect the presence of antibodies produced by the body in response to a viral infection that occurs in the body. This test does not directly detect the presence of EBV antibodies, but other antibodies that can arise when the body is infected with EBV. The monospot test is performed between the 4th and 6th week of the onset of symptoms of mononucleosis. This is because in the early weeks of infection, antibodies have not been fully formed.
- EBV antibody test, to detect the presence of specific antibodies against the EBV virus. This test can actually be done in the first week when you experience symptoms, but it can take a long time to get results.
Mononucleosis Treatment
Treatment for mononucleosis has not been found to date. Medical action is also not necessary because this disease can heal by itself within a few weeks through home treatment. Various steps of mononucleosis treatment that can be done are:
- Rest, to boost the immune system and help the body fight infection. Get plenty of rest, especially in the 1st to 2nd week since the initial symptoms appear.
- Increase fluid intake, to help relieve fever, treat sore throat, and prevent dehydration.
- Avoid strenuous activities such as extreme sports or lifting heavy weights too often, for at least 4-6 weeks after mononucleosis is diagnosed. This activity can cause swelling of the spleen. A strong enough impact can also cause a rupture of the spleen.
- Gargle with salt water, to relieve a sore throat. Dissolve 1.5 teaspoons of salt in a glass of warm water. Do it several times a day.
- Cold or hot compresses, to relieve muscle aches or pains.
- Avoid alcohol consumption to prevent liver dysfunction from getting worse.
The doctor will also prescribe medication to relieve the symptoms experienced by the patient, namely:
- pain reliever medicine,such as paracetamol or ibuprofen, to relieve muscle pain, as well as fever.
- Corticosteroids. A type of anti-inflammatory drug to relieve swelling of the tonsils and inflammation of the throat.
It is advisable to see a doctor again if the symptoms of mononucleosis do not subside or worsen after undergoing treatment, especially if you have difficulty swallowing food or liquids, have severe abdominal pain, or shortness of breath. If this happens, hospitalization is required.
After the infection has passed, the body will form a permanent immune system, so the chances of experiencing mononucleosis again are very small. However, in some patients, the virus can remain in the saliva in an inactive form. This virus can be transmitted to other people or reactivated under certain conditions.
Mononucleosis Prevention
Mononucleosis is a disease that is difficult to prevent. The only preventive measure that can be taken is to avoid direct contact with sufferers. This action can be done in the following way:
- Avoid kissing with sufferers
- Avoid sharing toothbrushes and eating or drinking utensils with sufferers
- Avoid exposure to splashes of saliva when the sufferer coughs or sneezes
- Have regular health checks.
Complications of Mononucleosis
Mononucleosis is not a serious disease. Although rare, complications can be experienced by some sufferers. These include:
- Spleen bleeding. Some people with mononucleosis experience swelling of the spleen. Impact from strenuous activity or exercise can make the swollen spleen rupture. This will cause internal bleeding in the stomach, which can be life threatening.
- Liver inflammation. Patients with mononucleosis are at risk for liver inflammation (hepatitis) which is characterized by the onset of jaundice.
- nervous disorders, such as Guillain-Barre syndrome (inflammation of the nervous system), meningitis, multiple sclerosis and encephalitis (inflammation of the brain).
- secondary infection, such as swollen tonsils (tonsillitis), sinus infections, and sore throat.
- Decrease in the number of blood cells in the body. A decrease in red blood cells (anemia) can cause shortness of breath and fatigue, while a decrease in white blood cells (neutropenia) makes the body susceptible to infection. A decrease in the number of platelets (thrombocytopenia) makes the patient prone to bleeding.
- heart disorders, For example, inflammation of the heart muscle (myocarditis).