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Saturday, May 5, 2007

“Kissing Disease” – Infectious Mononucleosis (Glandular Fever)

Infectious mononucleosis, also known as kissing disease,is a disease caused by the Epstein-Barr (EB) virus. This is a herpes type virus, which has also been implicated as the etiologic agent in Burkitt’s African jaw lymphoma, nasopharyngeal carcinoma and lymphoblastic leukemia, all occurring in human beings.
The disease occurs mostly in children and young adults. The exact mechanism of human transmission of this disease is not entirely known, but one important means is thought to be through “deep kissing” or intimate oral exchange of saliva. It is due to this reason that the disease is sometimes been called the “kissing disease.” It is known that oral excretion of the EB virus may continue for as long as 18 months following onset of the disease, although this excretion may be either constant or intermittent.

Clinical features
The disease is characterized by fever, sore throat, headache, chills, cough, nausea or vomiting and lymphadenopathy. Splenomegaly and hepatitis are also known to occur with considerable frequency. This disease is frequently seen in the epidermic form.
The cervical lymph nodes are usually the first to exhibit enlargement, followed by lymph nodes of the axilla and groin. Symptoms of pharyngitis and tonsillitis are common, but not invariably present and skin rash has been occasionally reported.
The majority of cases in children appear to be asymptomatic. Most of the cases are known to occur in 15 to 20 year old age group.

Oral manifestations
There are apparently no specific oral manifestations of this condition, although secondary lesions do occur. These are in the form of acute gingivitis and stomatitis. There is an appearance of a white or grey membrane in various areas, palatal petechiae and occasional oral ulcers. The occurrence of palatal petechiae is an early clinical diagnostic sign of infectious mononucleosis. Research shows that a few patients with hemorrhagic tendency exhibited oronasopharyngeal bleeding, including bleeding from the gingival.

There is no specific treatment for this disease. Various antibiotics have been used without great success. Bed rest and adequate diet are probably as good as any other therapy. The disease generally runs its course in two or three weeks and there are rarely any complications.

When to seek medical advice
If you've been feeling tired and weak; have had a persistent fever, headache, loss of appetite, rash and muscle aches; and have had swollen lymph nodes and tonsils — these are strong indications that you have mononucleosis. If rest and a healthy diet don't ease your symptoms within a week or two or if your symptoms recur, see your doctor.

Source: Text book of oral Pathology
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