Mononucleosis

Alternative Names

Treatment

Most patients recover within 2-4 weeks without medication. Younger children often don't have symptoms, while some older patients may have fatigue for up to 6 weeks.

There is no specific treatment available. Antiviral medications do not help. Steroid medication may be considered for patients with severe symptoms.

To relieve typical symptoms:

• Take acetaminophen or ibuprofen for pain and fever.
• Gargle with warm salt water for sore throat.
• Get plenty of rest. Drink plenty of fluids.
• Avoid contact sports while the 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. Fatigue usually goes away within a few weeks, but may linger for 2 to 3 months.

Possible Complications

• Secondary bacterial throat infection
• Rupture of spleen (this is rare; avoid pressure on the spleen)
• Neurological complications (these are rare, but include meningitis, seizures, ataxia, Guillain-Barre syndrome, and Bell's palsy)
• Hepatitis with jaundice (more common in patients older than 35)
• Hemolytic anemia
• Orchitis
• Death in immunocompromised individuals

When to Contact a Medical Professional

The initial symptoms of mono feel very much like a typical viral illness. It is not necessary to contact a health care provider unless symptoms last longer than 10 days or you develop the following:

• Severe sore throat or swollen tonsils
• Difficulty breathing
• Abdominal pain
• Severe headache
• Persistent high fevers (more than 101.5°F)
• Yellow discoloration of your eyes or skin
• Weakness in the arm or legs

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

• Sharp, sudden, severe abdominal pain
• Significant difficulty swallowing or breathing
• A stiff neck or severe weakness

References

Hoffman, R., ed. Hematology: Basic Principles and Practice. 4th ed. New York, NY: Churchill Livingstone, 2005.

Gershon, AA, Hotez, PJ, and Katz, SL, eds. Krugman’s Infectious Diseases of Children. 11th ed. St. Louis, Mo: Mosby; 2004.

Noble J, ed. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001.