- Severe sore throat
- Large red tonsils, sometimes covered with pus
- Swollen lymph nodes in the neck, armpits, and groin
- Fever for 7 to 14 days
- Enlarged spleen (in 50% of teens)
- Blood smear showing many atypical (unusual) lymphocytes
- Positive blood test for mononucleosis
Mononucleosis (mono) is caused by the Epstein-Barr virus (EBV). This virus is transmitted in infected saliva through coughing, sneezing, and kissing. Although mononucleosis can occur at any age, it occurs more often in 15 to 25 year olds, possibly because of more intimate contacts with others “kissing disease”. Contrary to popular belief, mono is not very contagious. Even people in the same household rarely come down with it.
Most teens have only mild symptoms for a week. Even those with severe symptoms usually feel completely well in 2 to 4 weeks. Complications are rare and may require hospitalization when they occur. The most common complication is dehydration from not drinking enough fluids. Breathing may be obstructed by enlarged tonsils, adenoids, and other lymph tissue in the back of the throat. On rare occasions, the enlarged spleen will rupture if the abdomen is hit or strained. Because over 90% of people with mononucleosis will develop a severe rash if they take Ampicillin or Amoxicilin, these medications should be avoided in this condition. A small number of patients with infectious mononucleosis may have fatigue even 6 months out.
Home Treatment for Mononucleosis:
Fever and pain medicines
No specific medicine will cure mononucleosis. However, symptoms can usually be helped with medicines. The pain of swollen lymph nodes and fever over 100.4 degrees F (38 degrees C) can usually be relieved by appropriate doses of acetaminophen or ibuprofen.
Sore Throat Treatment
Sipping warm chicken broth can be helpful. Sucking on hard candies may also relieve symptoms. Because swollen tonsils can make some foods hard to swallow, eat soft foods as long as necessary. To prevent dehydration, be sure that you drink enough fluids. Cold drinks are especially good. Avoid citrus fruits. Take a daily multivitamin until the appetite returns to normal. Again, acetaminophen or ibuprofen can be very helpful.
You don’t need to stay in bed. Bed rest will not shorten the course of the illness or reduce symptoms. You can decide how much rest you need. Slow down some until you no longer have a fever.
Precautions For An Enlarged Spleen
Your spleen may be enlarged while you have mononucleosis. A blow to the abdomen could rupture the enlarged spleen and cause bleeding. This is a surgical emergency. Therefore, all teens with mononucleosis should avoid contact sports for at least 6 weeks. Athletes especially must restrict their activity until the spleen returns to normal size (as determined by a physical exam.) Constipation and heavy lifting would also be avoided because of the sudden pressures they can put on the spleen. Your physician will need to reassess you until your spleen returns to a normal size.
Infectious mononucleosis is most contagious while you have a fever. After the fever is gone, the virus is still carried in the saliva for up to 6 months, but in small amounts. Overall mononucleosis is only slightly contagious from contacts. Boyfriends, girlfriends, roommates, and relatives rarely get it. The person with the mononucleosis does not need to be isolated. However, use separate drinking glasses and utensils and avoid kissing until the fever has been gone for several days. The incubation period for mononucleosis is 4 to 10 weeks after contact with an infected person. This means that if a person does become infected with the virus, the symptoms will not appear until 4-10 weeks after the contact.
CALL YOUR CHILD’S PHYSICIAN IMMEDIATELY IF:
- Breathing becomes difficult or noisy.
- Abdominal pain occurs (especially high on your left side).
- You start feeling very sick.
CALL YOUR CHILD’S PHYSICIAN DURING OFFICE HOURS IF:
- You can’t drink enough fluids.
- Signs of dehydration occur.
- Sinus or ear pain occurs.
- You aren’t back to school by 2 weeks.
- Any symptoms remain after 4 weeks.
- You have other questions or concerns.