Mononucleosis: the symptoms
The incubation of mononucleosis lasts between 30 and 50 days; this period is completely asymptomatic and corresponds to a replication phase of the viruses until reaching a critical viral load which leads to the clinical appearance of the disease. The last 3-4 days of incubation can be considered prodromal (when they precede the clinical manifestations of the disease), and are characterized by non-specific symptoms such as low-grade fever, widespread pain, asthenia. The overt symptoms include a feverish state, especially in the evening, with peaks that commonly reach 38 ° C but in the most serious cases they can be higher, even 40 ° C.
Before we proceed, let's debunk the myths about mononucleosis and the best ways to prevent it.
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After about 12 days, the following may appear: swollen lymph nodes (lymphadenopathy) in the neck, armpits and groin; jaundice (yellowish discoloration of the skin and eyes), a measles-like urticarial rash in 10-15% of cases (which resolves within 4-5 days), bruising-like areas inside the mouth, pain in the upper abdomen and through a clinical examination it is possible to highlight the enlargement of the spleen (Splenomegaly) and liver pain, this is most commonly manifested in the elderly. A traumatic rupture of the spleen can occur, favored by the enlargement of the organ itself, which would make it even more fragile. The liver can also enlarge, but more rarely.
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The important symptom in mononucleosis, which makes it possible to make an almost certain diagnosis, is the involvement of the lymph nodes. The first lymph nodes to swell are generally those belonging to the cervical, anterior and posterior chains. Gradually there is a swelling of some lymph nodes in many of the major superficial lymphatic stations of the body (axillary, supra and subclavicular, inguinal, popliteal). The enlarged lymph nodes are quite painful to palpation and are well mobile on the superficial and deep planes. Eyelid edema and gastroenteritis may also occur in children under the age of 5.
Symptoms such as fever and sore throat generally disappear within a few weeks, while the sense of fatigue and weakness, as well as the enlargement of the spleen, can last longer. mononucleosis should suggest an immediate medical consultation, especially for people who are debilitated or with an immune system compromised by drugs or diseases (eg HIV / AIDS), which greatly increases the risk of complications.
To learn more about mononucleosis, you can consult the website of the Niguarda Hospital.
