Infectious mononucleosis is caused by the ubiquitous EBV virus, which is estimated to infect 80% to 95% of the U.S. population. In infants, the disease is unremarkable and mimics the usual benign diseases of childhood. In adolescents and in young adults under the age of 35 years, primary infection with EBV can cause lymphadenopathy, fever, and pharyngitis, a symptom triad often called "mono," "glandular fever," or the "kissing disease." Treatment for symptoms consists of bed rest, increased fluid intake, and use of anti-inflammatory pain relievers. The disease is inflammatory and immune-related, and clinical experience suggests that corticosteroid drugs should be used because they dramatically relieve the symptoms and shorten the duration of fatigue. Corticosteroid drugs should be used also to treat the most common complications of mononucleosis, i.e., respiratory obstruction (from enlarged tonsils) and splenomegaly.
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