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chemoabi

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Angel
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What is Mononucleosis

 

Mono is a common illness, especially in young adults. It is caused by the Epstein-Barr Virus and it's a member of the herpesvirus family.

 

Most people have been exposed to the virus sometime in their life and have developed an immunity to the infection.

 

How is it spread

 

It is spread by person to person contact.  Saliva being the most common method.  Thats one of the reasons they called it the "kissing disease.'  Coughing,sneezing, inhaling mucous in the air are typical ways of getting infected.

 

Note, most people exposed to EBV will never develop the mononucleosis.

 

The incubation period which is the initial infection until symptoms occur is 4-6 weeks.  Since healthy people without symptoms also secrete the virus at different reactivation periods, isolation of the person with mono isnt necessary.

 

What are the symptoms?

 

Having a sore throat can really be a symptom of many conditions, and many people wonder if their own sore throat can be more serious than the common cold.  Mononucleosis and Strept throat are examples of two conditions that are more serious than the common cold and can cause an severe sore throat

 

The initial symptoms of mono are:

 

...a general lack of energy, fatigue or malaise.

...loss of appetite

...chills

 

These initial symptoms can last for days before the more intense symptoms of the illness occur.  The more common intense symptoms include:

 

...severe sore throat

...fever

...swollen lymph nodes in the neck area

...very reddened throat and tonsils

...Tonsils have a whitish coating in 1/3 of cases.

 

The spleen, sometimes referred to as the bodies biggest lymph node is located under the rib cage in the left upper abdominal area.  In some cases this can become inflamed and cause discomfort.

 

Other rare signs of mono could be an enlarged liver or a splotchy red raise looking similiar to measles.

 

What is the usual course of treatment?

 

In most cases of mono no specific treatment is necessary.  The illness is usually self limited and passes much the way other viruses resolve.  Treatment is directed toward the relief of symptoms.

 

...Antiviral medications:  They have relatively no effect on mono and in some cases can prolong the illness.

 

...Strept throat is common with mono and should be treated with Erythromycins.

 

...Ampicillin and Amoxocillin should be avoided because they will help cause a rash in 95% of the patients who take them.

 

...Tylenol for fever and any aching of the body or

    head.

 

...A sufficient amount of sleep and rest is

    important.

 

Conclusion

 

Mononucleosis is usually self limited, although sometimes prolonged, and often uncomfortable illness.  While specific treatment is rarely necessary, the potential complications make it essential that people with this illness be under the care of a physician.

 

Although rare, EBV has been associated with certain cancers, especially lymphomas.  This should be monitored in people with whose immune system has been compromised due to disease or immune suppressive drugs.  It has also been associated with one type of Hodgkins disease.

 

 


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Sheri

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Thanks for the info.  I do have a few more questions, though.  How do I know when I'm better?  How much time do I really have to rest?  Is a low white count normal with mono?  And why I am getting it now at my age?  I should already be immune.   This is a really frustrating disease.


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chemoabi

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Sheri:  Those are all good questions. 
 
1)  Regarding rest:  What I read was that the fatigue can last anywhere from 4 weeks to 6 months.  That doesnt mean you need to be in bed that whole time.  But do make sure not to over due things.
 
2)  You should be monitored by a doctor during the illness.  The sore throat should go away from 5-10 days after its onset.  Although, remember - the strept throat was an added pleasure.   The information I read said the symptoms will gradually go away similiar to a cold virus.
 
3)  The fatigue is probably the hardest to deal with.  So listen to your body and rest when you need to.
 
4)  Sometimes the lymphocytes can be elevated while the white blood cells are low.  This is where things get complicated.  Thats why I think you should talk to your onc.
 
5)  Why you got it at your age?  Its a mystery to me too.  Although you could have a rare case where you were exposed, but just like chicken pox - it can come out later as shingles.  Maybe because your immune system is still impaired, it couldnt fight it, and the Mono became active?  Thats a guess my friend.
 
6)  Frustrating doesnt even describe how I think you must be feeling.  When I read the symptoms, I realized you had been sick with this for a while.  Your PCP sorta missed the boat here.  What really upsets me - is that you pursued not feeling well, and you were made to feel like a hypochondriac.  I hate when doctors do that.  Then you had the addition complication of strept throat which in itself makes a person really sick.
 
Is your onc a hematologist too?  (a blood specialist).  Many of them are both.  But I think he/she needs to take a look at your blood work.  Also take a look at why your immune system is impaired.   PCP or Onc should be seeing you to monitor as you go along and check for any additional side effects.  My gut instinct says this is another gift from bc and all the treatment involved with it.
 
Nicki

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