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(Infectious Mononucleosis; Mono)

Mononucleosis – Definition

Mononucleosis is a viral disease characterized by fever, sore throat, swollen lymph glands, and fatigue.

Mononucleosis – Causes

Mononucleosis is usually caused by the Epstein-Barr virus (EBV). While other viruses can cause mono-like symptoms, EBV is generally thought to be the virus which causes mononucleosis. Found mainly in saliva and mucus, EBV is passed most efficiently from person-to-person by intimate behavior, such as kissing.

Mononucleosis – Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Many people contract EBV during their lifetime. Risk factors that increase the likelihood that EBV will develop into mononucleosis include:

  • Contracting EBV after the age of 10
  • Lowered immune resistance, due to other illness, stress, or fatigue
  • Living in close quarters with a large number of people, such as in a college dormitory

One episode of mononucleosis usually produces permanent immunity.

Mononucleosis – Symptoms

Signs of mononucleosis usually begin about 4-7 weeks after you were exposed to the virus. The initial symptoms may be a sense of general malaise that lasts about a week. This is followed by a set of signs and symptoms that may include:

  • High fever
  • Severely sore throat
  • Swelling of the lymph nodes
  • Fatigue
  • Loss of appetite
  • Muscle aches
  • Enlargement of the spleen
  • Swollen tonsils
  • Mild jaundice

Mononucleosis – Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Diagnosis is based on:

  • Your age
  • Four primary symptoms:
    • Fever
    • Swollen lymph nodes
    • Sore throat
    • Fatigue
  • Two primary tests:
    • Blood tests and “mono spot” tests
    • Throat culture (to check for strep throat, which can complicate mono)

Mononucleosis – Treatment

There is no treatment to cure mononucleosis or to shorten the length of illness. It usually runs its course in 4-6 weeks, although the fatigue may linger.

During the first few weeks after diagnosis, patients should avoid contact sports. Inflammation of the spleen from mononucleosis puts individuals at a high risk of splenic rupture. Rupture can require surgery, and in rare cases, it can be fatal.

Treatment includes:

Relief of Symptoms

  • Taking nonprescription pain relievers to lessen aches and pains and control fever
    • Avoid aspirin, especially in children.
  • Gargling with warm, salty water to relieve sore throat

Steroids are sometimes used if the swelling in the throat is interfering with breathing, or if a complication involving low platelet counts or anemia occurs. This treatment has not been shown to be helpful in mild cases.


  • Rest and fluids
  • No heavy lifting or exercise for at least several weeks after recovery (This decreases the risk of rupturing an enlarged spleen that may have developed as part of this illness.)

If you are diagnosed with mononucleosis, follow your doctor’s instructions.

Mononucleosis – Prevention

Most people contract the EBV virus sometime during their lives. Prevention is geared toward decreasing the likelihood that EBV will develop into mononucleosis. Follow these guidelines to decrease your risk:

  • Avoid intimate contact (especially kissing) with anyone who has active mononucleosis.
  • Eat a healthful diet.
  • Avoid excess stress.
  • Get enough rest.

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