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Mononucleosis

Contents of this page:

Illustrations

Mononucleosis, photomicrograph of cells
Mononucleosis, photomicrograph of cells
Mononucleosis, photomicrograph of cells
Mononucleosis, photomicrograph of cells
Infectious mononucleosis #3
Infectious mononucleosis #3
Acrodermatitis
Acrodermatitis
Splenomegaly
Splenomegaly
Infectious mononucleosis
Infectious mononucleosis
Mononucleosis, photomicrograph of cell
Mononucleosis, photomicrograph of cell
Gianotti-Crosti syndrome on the leg
Gianotti-Crosti syndrome on the leg
Mononucleosis - view of the throat
Mononucleosis - view of the throat
Mononucleosis - mouth
Mononucleosis - mouth
Antibodies
Antibodies

Alternative Names    Return to top

Mono; Kissing disease

Definition    Return to top

Mononucleosis is a viral infection causing fever, sore throat, and swollen lymph glands, especially in the neck.

See also: Infectious mononucleosis (acute CMV infection)

Causes    Return to top

Mononucleosis, or mono, is often spread by saliva and close contact. It is known as "the kissing disease," and occurs most often in those age 15 to 17. However, the infection may develop at any age.

Mono is usually linked to the Epstein-Barr virus (EBV), but can also be caused by other organisms such as cytomegalovirus (CMV).

Symptoms    Return to top

Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. The lymph nodes in the neck are frequently swollen and painful.

A pink, measles-like rash can occur and is more likely if you take the medicines ampicillin or amoxicillin for a throat infection. (Antibiotics should NOT be given without a positive Strep test.)

Symptoms of mononucleosis include:

Less frequently occurring symptoms include:

Exams and Tests    Return to top

During a physical examination, the doctor may find swollen lymph nodes in the front and back of your neck, as well as swollen tonsils with a whitish-yellow covering.

The doctor might also feel a swollen liver or swollen spleen when pushing on your belly. There may be a skin rash.

Blood work often reveals a higher-than-normal white blood cell (WBC) count and unusual-looking white blood cells called atypical lymphocytes, which are seen when blood is examined under a microscope. Atypical lymphocytes and abnormal liver function tests are a hallmark sign of the disease.

Treatment    Return to top

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:

You should also avoid contact sports while the spleen is swollen (to prevent it from rupturing).

Outlook (Prognosis)    Return to top

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    Return to top

When to Contact a Medical Professional    Return to top

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:

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

Prevention    Return to top

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    Return to top

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.

Update Date: 9/3/2008

Updated by: D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University.  Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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