Mononucleosis Health Article

Treatment

The goal of treatment is to relieve symptoms. Medicines such as steroids (prednisone) and antivirals (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

• Death in persons with weakened immune systems
• Hemolytic anemia
• Hepatitis with jaundice (more common in patients older than 35)
• Inflammation of the testicles (orchitis)
• Neurological complications (rare), including:
  • Guillain-Barre syndrome
  • Meningitis
  • Seizures
  • Temporary facial paralysis (Bell's palsy)
  • Uncoordinated movements (ataxia)
• Secondary bacterial throat infection
• Spleen rupture (rare; avoid pressure on the spleen)

Calling your health care provider

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:

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

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

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

Prevention

Persons with mononucleosis 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

Hurt C, Tammaro D. Diagnostic evaluation of mononucleosis-like illnesses. Am J Med. 2007 Oct;120(10):911.e1-8.

Jenson HB. Epstein-Barr Virus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 251.