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Mononucleosis

Mononucleosis ("Mono") is a viral illness of adolescents and young adults. Its course can be mild, moderate or quite severe. It is diagnosed either by the usual signs and symptoms of the illness, or through a blood test. Regardless of severity, it usually resolves within 4-6 weeks and has no long-term effects. It is unrelated to strep throat, although both can coexist.

The main symptoms are low-grade fever, sore throat and enlarged, tender lymph glands. The tonsils are usually swollen and covered with a grayish membrane. Sometimes there is a rash and particularly so if the person is taking the antibiotic Amoxicillin during the illness.

Mono is transmitted by close personal contact or kissing. It has an incubation period of about a month, but this varies quite a bit. Mono is considered contagious for 6 months after onset of the illness, yet it is very rare for other family members to become ill with it.

Since it is a viral illness, there is no cure. Generally it resolves without any long-term effects, but there are some complications that can be potentially dangerous.

Home Care for Mononucleosis

  • Fluids, rest and proper nutrition are the mainstays of treatment. Fatigue is common and extra rest is frequently necessary. It is probably best to avoid work or school during the height of the illness or while running a fever.

  • In addition to swollen lymph glands, the spleen is often enlarged. This organ is just under the rib cage in the left upper abdomen and can be easily injured. This leads to severe internal bleeding. Avoid all contact sports for at least 6 weeks.

  • The throat pain can be reduced somewhat by warm salt-water gargles (a teaspoon in 8 oz.) or half strength peroxide. Ibuprofen will help with fever and aches if not sensitive to it.

  • Sometimes the diagnosis is not clear at the time of the first visit. Since the blood test is not usually positive during the first 7-10 days of the illness, you may be advised to recheck with your own physician if symptoms persist for over a week.

  • Swollen tonsils can be a problem with both pain and potential blockage of the airway. If this is an issue, sometimes cortisone medications are prescribed for a short while. These will help reduce the symptoms, but can actually prolong the illness.

 

Call or Return If Any of the Following Occur:

  • Significant trouble swallowing or increased effort of breathing
  • Bad pain in the abdomen or left shoulder

  • Skin rash, particularly if you have been taking Ampicillin, Amoxicillin or Augmentin. (Do not take these medications if mono is suspected.)

  • Jaundice or yellow eyes or skin

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