Chronic throat infections after having mono

[pamela44261]

In August of 2008 I was diagnosed with having mono. I had already had it for about a month and half but I was deployed in Iraq (I'm in the army) and the docs I went to kept insisting it was strep throat until they finally did the mono test. So after a few months I was fine then during the holidays I started to get chronic sore throats with white excudate on my tonsils, head aches and swollen glands all along the left side of my neck. I was told it was just a viral infection and it would go away. Then I redeployed to the states and the infections kept persisting on and off again. During this past summer in July I started to get bad migraines with the sore throats and I also lost my voice for a few days. I saw one of my clinics PA's and she tested me and told me I had chronic mononucleosis. Basically there wasn't going to be anything to do for me and I would have to live with it. Then a month later she left and I was told to she the head doc at the clinic in charge. He said he never heard of chronic mono and didn't think there was anything wrong with me, even though I had white excudate on my tonsils at the time also.
This is a problem I've had to deal with for over a year and I'm sick of it. I feel tired all the time, have chronic sore throats with white excudate on my tonsils all the time. I also get migraines every once in a while now and the glands on the left side of my neck will swell up from time to time. I haven't been able to get any help or a second opinion and if I could get any help at all from anyone it would be greatly apreciated. Thank you.

[David Tinkelman, M.D.]

Yours is a complicated health problem.  Acute Infectious Mononucleosis (IM) can commonly persist for 3-4 months after the acute infection and be associated with a variety of symptoms including fatigue, headache, exudative sore throat, fever and lymph node enlargement and, less commonly but certainly not rare, involvement of other organs, most notably liver and spleen.  It is rare that symptoms, such as yours, should persist for more than 6 months but it can occur.  Because it is so rare (see following abstract) for the time frame to exceed 6 months, when it happens further detailed evaluation of the disease by an Infectious Disease Specialist is warranted.  You should request such consultation, as other diseases may mimic IM or simply be associated with it, for example chronic recurrent strep pharyngitis (strep throat).  The preceding can also be associated with an immunodeficiency state (an immune system problem) but can occur in persons with normal immunity.  Yours is a legitimate, potentially serious illness that should not simply be “written-off” as something inconsequential that will eventually clear-up.

Your request for specialist consultation is unquestionably  justified and your current doctor(s) should assist you with the referral.

Good luck,



Information from Medical literature follows:


Authors Full Name
Brkic, Snezana. Jovanovic, Jovana. Preveden, Tomislav.

Institution
Klinika za infektivne bolesti, Klinicki centar, Novi Sad. ***@****

Title
[Chronic infectious mononucleosis]. [Serbian]

Source
Medicinski Pregled. 56(7-8):366-72, 2003 Jul-Aug.

Abstract
INTRODUCTION: Chronic infectious mononucleosis is a clinical entity recognized 15 years ago with clearly defined serological criteria: high titres of IgG Epstein-Barr virus (EBV) virus capsid antigen (VCA), IgG EBV early antigen without IgG Epstein-Barr nuclear antigen (EBNA) antibodies. MATERIAL AND METHODS: This follow-up study lasted for 2 years and included 100 acute infectious mononucleosis patients who were investigated every 6 months. Apart from physical examination we evaluated history, complete blood count and liver function together with 5 commercial ELISA tests: IgM EBV VCA, IgG EBV VCA, IgG EB NA, IgG EBV EA and IgA EBV EA. RESULTS: Although malaise and fatigue with cervical lymphoadenopathy were the most frequent symptoms, their statistical significance was most established. All laboratory analyses were completely normal during the follow-up period, but there were four patients with acute hepatitis due to hepatitis A virus and adenoviruses. After 6 months of acute illness, two patients without IgG EB NA antibodies who were candidates for chronic disease, presented no other serological findings for chronic disease. It was confirmed that they had delayed serological response due to EBV infection, because one year later they had a completely normal immune status on EBV infection. CONCLUSION: Chronic infectious mononucleosis seems to be an extraordinary event after acute disease. This conclusion corresponds with literature reports of sporadic cases of this disease