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The Journal of the American Board of Family Practice, Vol 14, Issue 4 234-242, Copyright © 2001 by American Board of Family Practice

ARTICLES

Prospective study of the natural history of infectious mononucleosis caused by Epstein-Barr virus

T. D. Rea, J. E. Russo, W. Katon, R. L. Ashley and D. S. Buchwald
Department of Medicine, University of Washington, Seattle, USA.

BACKGROUND: Knowledge regarding the clinical characteristics and natural history of acute infectious mononucleosis is based largely on older, often retrospective, studies without systematic follow-up. Differences in diagnosis, methodology, or treatment between historical and current practice might affect an understanding of this illness. METHODS: Using a prospective case series design, we enrolled 150 persons with an acute illness serologically confirmed as Epstein-Barr virus infection. The goal of the study was to assess symptoms, physical examination findings, laboratory tests, and functional status measures during the acute presentation and 1, 2, and 6 months later. RESULTS: Acutely, infectious mononucleosis was characterized by the symptoms of sore throat and fatigue and substantial functional impairment. Objective physical and laboratory examination findings included pharyngitis and cervical lymphadenopathy, a moderate absolute and atypical lymphocytosis, and mildly elevated transaminase levels. The traditional signs of fever and splenomegaly were relatively uncommon. By 1 month, most symptoms and signs and all laboratory tests had returned to normal. Fatigue, cervical lymphadenopathy, pharyngitis, and functional health status improved more slowly. CONCLUSIONS: In contemporary practice most of the classical illness features of infectious mononucleosis are observed. Symptoms, signs, and poor functioning might be protracted in some patients.


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I. Petersen, J.M. Thomas, W.T. Hamilton, and P.D. White
Risk and predictors of fatigue after infectious mononucleosis in a large primary-care cohort
QJM, January 1, 2006; 99(1): 49 - 55.
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