CMV Mononucleosis

Alternative names

Infectious mononucleosis (CMV); Acute acquired cytomegalovirus infection; Cytomegalovirus (CMV)

Definition

Infectious mononucleosis is an acute viral infection that can cause high fever, sore throat, and swollen lymph glands, especially in the neck. Unlike the more common form of mononucleosis, caused by the Epstein-Barr virus, this type is caused by cytomegalovirus (CMV).

Causes, incidence, and risk factors

Infectious mononucleosis can be caused by several different viruses and a few types of bacteria. Less commonly, it is caused by parasites.

The most commmon causes are the Epstein-Barr virus (EBV) and cytomegalovirus (CMV), both members of the herpesvirus family. The symptoms of infection, including sore throat, occur less commonly with CMV than with EBV.

The infection is transmitted by saliva, sexual contact, respiratory droplets, and blood transfusions. While the peak incidence occurs in 15- to 17-year-olds, the infection may occur at any age, most often between the ages of 10 and 35.

Abnormal or atypical lymphocytes (white blood cells) are seen in the peripheral blood, and may persist for 2 to 8 weeks. Abnormalities of liver function are also characteristic. Risk factors other than age are not known. The vast majority of people are exposed to CMV early in life and do not realize it because they have no symptoms.

Symptoms

• Fever
  
• Sore throat
  
• Enlarged lymph nodes, especially in the neck
  
• Malaise (vague ill feeling)
  
• Frequent tiredness or fatigue
  
• Loss of appetite
  
• Muscular aches or stiffness
  

Less common symptoms include:

• Jaundice (yellow cast to skin)
  
• Headache
  
• Neck stiffness
  
• Sensitivity to light
  
• Cough
  
• Shortness of breath
  
• Chest pain
  
• Rapid heart rate
  
• Irregular heart rate
  
• Hives
  

Signs and tests
A physical examination reveals an enlarged liver or an enlarged spleen. The liver and spleen may be tender when they are gently pressed (palpated). There may be a skin rash.