- abdominal tenderness
- slight JAUNDICE(yellow discoloration of the SKIN)
The diagnostic path includes BLOODtests; the
presence of abnormal lymphocytes and antibodies
for Epstein-Barr virus confirms the diagnosis.
Some people have mild HEPATITIS(INFLAMMATIONof
the LIVER), which blood tests also confirm, and
mild to moderate SPLENOMEGALY(enlarged SPLEEN),
which the doctor can detect with palpation (by
feeling the abdomen).
Treatment Options and Outlook
Treatment is supportive, with rest and plenty of
fluids. The course of illness may run three to six
weeks, during which time the person is contagious
and can spread the infection to other people. Most
people recover fully, though it may take several
months to feel back to normal. Though infectious
mononucleosis is generally a benign, self-limiting
viral infection, the Epstein-Barr virus remains in
the body for life and is linked to certain kinds of
cancer (notably Burkitt’s lymphoma). A person
can have infectious mononucleosis only once; the
body develops IMMUNITYwith infection.
Risk Factors and Preventive Measures
The Epstein-Barr virus is ubiquitous in the world;
avoiding infection is nearly impossible. Measures
such as frequent HAND WASHING and appropriate
SNEEZE/COUGH ETIQUETTEreduce the risk for passing
the infection to others. Adequate rest during the
active illness reduces the risk for complications.
See also ANTIBODY; ANTIBODY-MEDIATED IMMUNITY;
B-CELL LYMPHOCYTE; LYMPHOCYTE.
mumps An illness resulting from the mumps
VIRUS, which primarily infects the SALIVARY GLANDS
and may also involve the PANCREAS, TESTICLES
(men), OVARIES(women), and sometimes the KID-
NEYS. The mumps virus may also invade the CEN-
TRAL NERVOUS SYSTEM, causing NEURITIS and
ENCEPHALITIS. Since the advent of the mumps VA C-
CINEin the early 1980s, mumps infections have
become uncommon in the United States and now
tend to occur in adults who did not have the
INFECTIONas children. Infection with mumps con-
fers lifelong IMMUNITY, as does vaccination.
The mumps virus is contagious through contact
with saliva, either direct or via airborne droplets.
After an INCUBATION PERIODof 14 to 21 days, symp-
toms emerge that include- painful swelling of the parotid salivary glands at
the base of the EAR - HEADACHE
- sore THROAT
- FEVER
Swollen testicles are common in boys and
lower abdominal PAIN, reflecting ovarian swelling,
is common in girls. The classic “eat a pickle” test
for mumps has some merit in that eating sour
foods greatly intensifies the pain. However, the
doctor usually makes the diagnosis on the basis of
the symptoms and history of exposure or lack of
IMMUNIZATION. Treatment targets symptom relief.
Most people recover fully. A small percentage of
people, usually adults, who acquire mumps infec-
tion develop neurosensory HEARING LOSS that is
usually temporary. Mumps infection in both testi-
cles (bilateral testicular mumps) can cause sterility,
though this is uncommon. Though mumps
encephalitis and MENINGITISare serious complica-
tions, they are seldom fatal and most people
recover without long-term consequences.
See also CHICKENPOX; CHILDHOOD DISEASES;
MEASLES.mumps 345