Mononucleosis is a viral infection causing fever, sore throat, and swollen lymph glands, especially in the neck.
See also: Infectious mononucleosis (acute CMV infection)
Causes, incidence, and risk factors
Mononucleosis, or mono, is often spread by saliva and close contact. It is known as "the kissing disease," and occurs most often in those age 15 to 17. However, the infection may develop at any age.
Mono is usually linked to the Epstein-Barr virus (EBV), but can also be caused by other organisms such as cytomegalovirus (CMV).
Symptoms
Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. The lymph nodes in the neck are frequently swollen and painful.
A pink, measles-like rash can occur and is more likely if you take the medicines ampicillin or amoxicillin for a throat infection. (Antibiotics should NOT be given without a positive Strep test.)
Symptoms of mononucleosis include:
Drowsiness
Fever
General discomfort, uneasiness, or ill feeling
Loss of appetite
Muscle aches or stiffness
Rash
Sore throat
Swollen lymph nodes, especially in the neck and armpit
Swollen spleen
Less frequently occurring symptoms include:
Chest pain
Cough
Fatigue
Headache
Hives
Jaundice (yellow color to the skin)
Neck stiffness
Nosebleed
Rapid heart rate
Sensitivity to light
Shortness of breath
Signs and tests
The doctor or nurse will examine you. This may show that you have:
Swollen lymph nodes in the front and back of your neck
Swollen tonsils with a whitish-yellow covering
Swollen liver or spleen
Skin rash
Blood tests will be done, including:
White blood cell (WBC) count - will be higher than normal
Monospot test - will be positive for infectious mononucleosis.
Antibody titer - tells the difference between a current and previous infection
Treatment
The goal of treatment is to relieve symptoms. Steroid medicine (prednisone) may be given if symptoms are severe.
Antiviral drugs such as acyclovir have little or no benefit.
To relieve typical symptoms:
Drink plenty of fluids.
Gargle with warm salt water to ease a sore throat.
Get plenty of rest.
Take acetaminophen or ibuprofen for pain and fever.
You should also avoid contact sports while the spleen is swollen (to prevent it from rupturing).
Expectations (prognosis)
The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Fatigue usually goes away within a few weeks, but may linger for 2 to 3 months.
Complications
Complications of mononucleosis may
