Yuck! Did someone say kissing bug? Ok we don't mean an actual insect but we are going to talk about mononucleosis or Epstein Barr virus (EBV) and explain where the term "kissing bug" came from.

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

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Key points:

• EBV is human herpesvirus 4 affecting B-cells and spreads through saliva or blood transfusions. About 90% of US adults are infected with it!
• Symptoms of EBV are typical mild upper respiratory symptoms including fever, cough, rhinorrhea, and sore throat that can look like palatal petechiae and tonsillar exudate on exam. EBV can appear similar to strep which is why testing is important to differentiate
• Because EBV is a virus, treatment is usually supportive but severe disease or immunocompromised patients may be given antivirals, immunomodulators, and/or steroids

Sources

• Red Book Epstein-Barr Virus Infections (Infectious Mononucleosis)
• “Epstein-Barr Virus”. Pediatr Rev (2011) 32 (9): 375–384. https://doi.org/10.1542/pir.32-9-375
• “Cytomegalovirus and Epstein-Barr Virus Infections”. Pediatr Rev (2016) 37 (6):223–234. https://doi.org/10.1542/pir.2015-0072
• Luzuriaga K, Sullivan JL. Infectious mononucleosis. N Engl J Med. 2010;362(21):1993-2000. doi:10.1056/NEJMcp1001116