Infectious Mononucleosis

What is infectious mononucleosis (mono)?

From: MedlinePlus, National Library of Medicine

Infectious mononucleosis (mono) is a disease caused by viruses.The most common cause is the Epstein-Barr virus (EBV). Mono is contagious, which means it can spread from person to person. It is common among teenagers and young adults, especially college students.

What causes infectious mononucleosis (mono)?

From: MedlinePlus, National Library of Medicine

Mono can be caused by many different viruses. But it is most often caused by the Epstein-Barr virus (EBV). EBV is found all over the world. Most people get an EBV infection at some point in their lives, but only some of them will get the symptoms of mono. EBV infections often happen during childhood or when someone is a young adult. EBV infections in children usually do not cause symptoms. And when they do, it's hard to tell the difference between the symptoms of mono and the symptoms of other common childhood illnesses such as the flu. Teens and young adults who get EBV are more likely to have symptoms that are typical of mono.

EBV and the other viruses that cause mono are usually spread through body fluids, especially saliva (spit). This means that you can get it through kissing. That's why mono is sometimes called "the kissing disease." But you can also get these viruses if you share food, drinks, forks, spoons, or lip balm with someone who has mono. Other less common ways of getting an infection are through blood transfusions, organ transplants, and blood and semen during sexual contact.

What are the symptoms of infectious mononucleosis (mono)?

From: MedlinePlus, National Library of Medicine

The symptoms of mono usually start four to six weeks after you get the infection. But they may start sooner in young children. The symptoms often develop slowly, and they may not all happen at the same time. They can include:

• Extreme fatigue
• Fever
• Sore throat
• Head and body aches
• Swollen lymph glands in your neck and armpits
• Rash
• Swollen liver, spleen, or both (these are less common symptoms)

Most people get better in two to four weeks. However, some people may feel fatigued for several more weeks. Occasionally, the symptoms can last for six months or longer.

How is infectious mononucleosis (mono) diagnosed?

From: MedlinePlus, National Library of Medicine

Your healthcare provider may diagnose mono based on your symptoms and a physical exam. The exam will include checking to see if your lymph nodes, tonsils, liver, or spleen are swollen. In some cases, your provider might also order a mono test to confirm the diagnosis.

What are the treatments for infectious mononucleosis (mono)?

From: MedlinePlus, National Library of Medicine

If you have severe symptoms, your provider may suggest additional treatment based on which organs in your body are affected by the mono.

Antibiotics don't treat viral infections, so they do not help with mono. Some people do get bacterial infections such as strep throat along with mono. In that case, you probably need antibiotics to treat the bacterial infection. But you should not take penicillin antibiotics like ampicillin or amoxicillin. Those antibiotics can cause a rash in people who have mono.

Mono can cause an enlarged spleen, which could rupture and cause a medical emergency. To try to protect the spleen, providers recommend avoiding intense exercise and contact sports until you fully recover (about a month).

• Drinking plenty of fluids to avoid dehydration.
• Getting lots of rest.
• Taking over-the-counter medications for pain and fever. But don't give aspirin to children or teens because it may cause Reye syndrome. This syndrome is a rare, serious illness that can affect the brain and liver.

Can infectious mononucleosis (mono) be prevented?

From: MedlinePlus, National Library of Medicine

There is no vaccine to protect against mono. To lower your chance of getting or spreading mono:

• Don't share food, drinks, forks, spoons, or lip balm with anyone, especially if you or the other person has mono.
• Don't kiss someone if you or the other person has mono.
• Wash your hands often with soap and water.

Which doctor should you see?

The suggested department for discussing Infectious Mononucleosis is Infectious Diseases, with a general physician / infectious disease specialist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which exposure or organism is suspected, and what evidence would confirm it?
• Are precautions, vaccination or advice for close contacts relevant to this infection?
• What should happen if symptoms worsen or do not improve as expected?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.