Mononucleosis in older adults

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Mononucleosis, also called "mono," is a common illness that can leave you feeling tired and weak for weeks or months. Mono goes away on its own, but lots of rest and good self-care can help you feel better. It is most often seen in teens and young adults.

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Although Epstein-Barr virus EBV infections are often asymptomatic, some patients present with the clinical syndrome of infectious mononucleosis IM. The syndrome most commonly occurs between 15 and 24 years of age. It should be suspected in patients presenting with sore throat, fever, tonsillar enlargement, fatigue, lymphadenopathy, pharyngeal inflammation, and palatal petechiae.

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Epstein-Barr virus EBV is the most common cause of infectious mononucleosis, but other viruses can also cause this disease. It is common among teenagers and young adults, especially college students. At least one out of four teenagers and young adults who get infected with EBV will develop infectious mononucleosis.

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Infectious mononucleosis mono is often called the kissing disease. The virus that causes mono is transmitted through saliva, so you can get it through kissing, but you can also be exposed through a cough or sneeze, or by sharing a glass or food utensils with someone who has mono. However, mononucleosis isn't as contagious as some infections, such as the common cold.

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While usually caused by Epstein—Barr virus, also known as human herpesvirus 4, which is a member of the herpes virus family[3] a few other viruses may also cause the disease. There is no vaccine for EBV, but infection can be prevented by not sharing personal items or saliva with an infected person. Mono most commonly affects those between the ages of 15 to 24 years in the developed world.

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These patients are less likely than younger patients to have lymphadenopathy and pharyngitis; fever is generally the most prominent symptom and often lasts longer than 2 weeks. Splenomegaly is caused by the infiltration of the spleen with lymphocytes and atypical lymphoid cells. Physical exam has been found to be unreliable in diagnosing splenomegaly in tall individuals as their spleen size often falls outside of the normal range for the general population.

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Riverside, Calif. Such was the happy outcome in this case of infectious mononucleosis in a year-old man. The patient, a retired teacher, normally quite alert, had had a myocardial infarction in February and another in March At the time of his first episode a diminished right carotid pulse had been noted.

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This acute condition, also called infectious mononucleosis, is caused by the Epstein-Barr virus EBV and is now a rite of passage for many young people. EBV is spread through contact with saliva — hence its nickname — but it can also be caught from sharing cups or utensils. Although it is more common in high school and university-aged students, glandular fever can occur later in life; and similarly to other illnesses, it tends to be more severe in older people.

Spyros P. Because of uncommon presentation and misdiagnosis, clinical manifestations are less well described in older age. We present two cases of elderly patients with predominant symptoms attributed to cold agglutinin haemolytic anaemia due to acute EBV infection without fever, lymphadenopathy, pharyngitis or splenomegaly. We conclude that misleading clinical manifestations are frequent in older individuals and may lead to inappropriate diagnostic invasive procedures.


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