Understanding Mononucleosis: Causes, Symptoms, and Treatment Options

Creator: Doctronic
Published: 2023-06-18

Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on June 18th, 2023.

Key Takeaways

Epstein-Barr virus (EBV) causes 90% of cases, with cytomegalovirus and other viruses accounting for the remainder—spread occurs through saliva, shared utensils, and close contact.
Peak onset occurs between ages 15-25, though 95% of adults show evidence of past EBV infection by age 40, often without realizing they had it.
Fever typically resolves within 10-14 days, but severe fatigue can persist for 2-6 months as the immune system continues fighting the infection.
Spleen enlargement occurs in 50-60% of patients, creating rupture risk that mandates avoiding contact sports, heavy lifting over 10 pounds, and abdominal trauma for 4-6 weeks.
Corticosteroids may be prescribed for severe throat swelling that impairs breathing or swallowing, but routine use isn't recommended due to potential immune suppression.

Mononucleosis, often called "mono" or "the kissing disease," is an infectious illness usually caused by the Epstein-Barr virus (EBV). While it's not typically serious, mono can cause a range of symptoms and may take some time to recover from. In this article, we'll explore the causes, symptoms, and treatment options for mono, as well as how to manage the illness and prevent its spread.

What Causes Mononucleosis?

The Epstein-Barr virus is responsible for the majority of mononucleosis cases. However, other viruses, such as adenoviruses, cytomegalovirus (CMV), hepatitis types A, B, or C, herpes simplex virus, HIV, and rubella, can also cause mono. EBV is part of the herpes virus family and is spread through bodily fluids, primarily saliva. This is why mono is sometimes called "the kissing disease."

You can contract mono by kissing someone who has the virus, sharing food, drinks, or utensils with an infected person, or rarely, through coughing or sneezing. EBV can also be spread through blood and semen, although this is less common.

Symptoms of Mononucleosis

Mono symptoms can vary from person to person, and some people may not experience any symptoms at all. Common symptoms of mono include:

Fever
Fatigue
Sore throat
Swollen lymph nodes
Sore muscles
Loss of appetite
Rash

Less common symptoms may include a cough, chest pain, shortness of breath, headache, nosebleeds, a fast heartbeat, a stiff neck, hives, or jaundice.

Understanding Mononucleosis: Causes, Symptoms, and Treatment Options

Diagnosing Mononucleosis

Doctors can usually diagnose mono based on a patient's symptoms and a physical examination. They may also order blood tests, such as a complete blood count (CBC) or antibody tests, to confirm the diagnosis. It's important to note that mono can sometimes be mistaken for strep throat, as they share some similar symptoms. However, strep throat is caused by bacteria, while mono is typically caused by a virus.

Treating Mononucleosis

There is no specific cure for mono, and antibiotics and antivirals are not effective against EBV. Treatment focuses on managing symptoms and allowing the body to fight off the infection. Some helpful strategies include:

Getting plenty of rest
Staying hydrated
Using over-the-counter pain relievers for fever and pain
Gargling with salt water to ease throat pain
Taking corticosteroid medication for severe throat swelling

Most people with mono will start to feel better within 2-4 weeks, although fatigue can linger for several weeks or even months. In some cases, it may take up to 6 months for symptoms to completely resolve.

Managing Mononucleosis and Preventing Its Spread

If you have mono, it's essential to rest as much as possible to help your body recover. You may need to take time off from school or work until your symptoms improve. It's also important to avoid strenuous activities, such as sports or heavy lifting, for about a month to reduce the risk of rupturing your spleen, which can become enlarged due to the infection.

To prevent the spread of mono, practice good hygiene, such as washing your hands frequently and avoiding sharing personal items like drinks, utensils, or toothbrushes. While there is no vaccine to prevent mono, taking these precautions can help reduce your risk of contracting the virus.

When to Seek Medical Attention

While mono is usually not serious, complications can occur in some cases. Seek medical attention if you experience any of the following:

Difficulty swallowing or breathing due to swollen tonsils
Severe abdominal pain, which may indicate a ruptured spleen
Yellowing of the skin or eyes (jaundice)
Persistent high fever
Seizures or neck stiffness, which may indicate a nervous system complication

If you suspect you have mono or are experiencing severe symptoms, consult your healthcare provider for proper diagnosis and treatment.

Conclusion

Mononucleosis is a common infectious illness that can cause a variety of symptoms and may take some time to recover from. By understanding the causes, symptoms, and treatment options for mono, you can better manage the illness and prevent its spread. Remember to rest, stay hydrated, and seek medical attention if you experience severe or concerning symptoms.

For more information on mononucleosis, visit:

The Bottom Line

Recovery requires strict activity restrictions to prevent potentially life-threatening spleen rupture, while managing symptoms with rest and supportive care as the infection runs its course. Most patients return to normal activities within 4-6 weeks, though some experience lingering fatigue for months. If you're dealing with persistent exhaustion, severe throat pain, or swollen lymph nodes, Doctronic can help you get proper evaluation and guidance.