Kissing disease
Kissing disease is a self-limited benign lymphoproliferative disease caused by the Epstein-Barr virus (EBV), which occurs most often in adolescents and young adults.
Clinically it presents with a triad of fever, exudative pharyngitis and lymphadenopathy, in the immunological studies it is observed in the blood atypical T and B lymphocytes (defense cells of our immune system) and heterophilic antibodies of IgG nature (Immunoglobulins capable of reacting with antigens different from those that gave rise to it). Mortality is rare and full recovery is usual over a period of two to three weeks.
The Epstein-Barr virus is related to the pathogenesis of several lymphomas and nasopharyngeal cancer, belongs to the Herpeviridae family, in some cases it is co-infected with other viruses constituting a source of risk for the development of lymphoproliferative activities, it is a Universal distribution disease, mostly benign or asymptomatic, is very common in high social classes. The reservoir is humans and some primates, the mode of transmission is from person to person through the oropharyngeal route through saliva. Young children can become infected by the saliva present in the hands of the people who care for it. The kiss facilitates dissemination among young adults, transmission by blood transfusions to susceptible receptors is also described, but it is rare to manifest clinically.
The incubation period for EBV infection is 4 to 6 weeks. The excretion of the virus by the pharynx may persist for a year or more after infection and approximately 20% of healthy adults who have antibodies against EBV are healthy carriers of the virus (pharynx) for a long time. Susceptibility is general and the infection confers a high degree of resistance.
The disease begins with chills, fever (95%), headache, malaise, sore throat (odynophagia) and enlarged lymph nodes which are painful. The pharynx and tonsils are covered with a white-yellowish exudate, with petechial lesions on the palate in half of the cases, in 25-75% they present splenomegaly (enlargement of the spleen) and in 50% hepatosplenomegaly (increase the size of the liver and spleen).
In people older than 40 years it can be acquired parenterally (transfusions), being a prolonged evolution probably due to the high frequency of liver dysfunction.
