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Mononucleosis

Definition

Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.

Alternative Names

Mono; Kissing disease; Glandular fever

Causes

Mono is often spread by saliva and close contact. It is known as "the kissing disease." Mono occurs most often in people ages 15 to 17, but the infection may develop at any age.

Mono is usually linked to the Epstein-Barr virus (EBV). Rarely, it is caused by other viruses, 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. Often, the lymph nodes in the neck are swollen and painful.

A pink, measles-like rash can occur, and is more likely if you take the medicine ampicillin or amoxicillin for a throat infection. (Antibiotics should NOT be given without a test that shows you have a strep infection.)

Common symptoms of mono include:

Less common symptoms:

Exams and Tests

Your health care provider will examine you. The exam may find:

Blood tests will be done, including:

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:

You should also avoid contact sports if your spleen is swollen (to prevent it from rupturing).

Outlook (Prognosis)

The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Tiredness usually goes away within a few weeks, but it may linger for 2 to 3 months.

Possible Complications

Complications of mononucleosis may include:

Death is possible in people who have a weakened immune system.

When to Contact a Medical Professional

The early symptoms of mono feel very much like any other illness caused by a virus. You do not need to contact a health care provider unless your symptoms last longer than 10 days or you develop:

Call 911 or go to an emergency room if you develop:

Prevention

People with mono may be contagious while they have symptoms and for up to a few months afterwards. How long someone with the disease is contagious varies. The virus can live for several hours outside the body. Avoid kissing or sharing utensils if you or someone close to you has mono.

References

Frye R, Bailey J, Blevins AE. Clinical inquiries. Which treatments provide the most relief for pharyngitis pain? J Fam Pract. 2011;60:293-294.

Jenson HB. Epstein-Barr virus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 246.

Schooley RT. Epstein-Barr virus infection. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 385.

Weber R. Pharyngitis. In: Bope ET, Kellerman RD, eds. Conn's Current Therapy 2012. 1st ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 1.


Review Date: 5/12/2014
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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