Mononucleosis

Once exposed to the virus, the incubation period before symptoms arise is 4-6 weeks. Once symptoms arise, it is usually several weeks before they clear up. However, most report that they don’t feel completely recovered for a couple months. The best treatments for mono are rest and adequate fluid intake. Antibiotics don’t help with a viral infection, unless there is a secondary strep or sinus infection. In that case, an antibiotic may be prescribed, but it is best to avoid amoxicillin or other penicillin derivatives as they can lead to a rash in mono victims. Plenty of bed rest is the main treatment and will lead to a quicker recovery. In those who try to resume their routine too soon, relapse is a risk. In addition to rest, one should drink plenty of water/fluids to relieve fever and prevent dehydration. Pain/fever relievers such as acetaminophen or ibuprofen can be taken, and salt water gargles several times per day (1/2 t. salt and 8 oz water) can relieve a sore throat.

Most cases of mono will resolve with the simple treatments listed above, but there are a few complications that your health care provider will monitor you for. As with most viral illnesses, these complications are going to be more closely monitored in those with weakened immune systems.

• Spleen: An enlarged spleen is a possible health concern in those with mono and should be monitored by a health care provider. Care should be taken to refrain from physical activity that could possibly lead to any insult to this area of the body. The activities that should be limited for at least a month are heavy lifting, roughhousing, and any contact sports or vigorous activities. A ruptured spleen would cause sudden, sharp pain in the upper left abdomen and needs immediate medical attention.
• Liver: Occasionally, those with mono will be at risk for liver inflammation (hepatitis) and jaundice (yellowing of the skin or sclera). These symptoms should be shared with a health care provider.
• Swollen tonsils: This complication has been reported to interfere with eating, drinking, and (rarely) breathing difficulties
• Blood Irregularities: Anemia and low platelet count are uncommon complications
• Heart and nervous system problems are rarely seen

Mono can be diagnosed with a simple blood test (finger prick) right in our clinic in just a few minutes. The physical assessment will include monitoring vital signs, throat swab (to rule out strep or secondary infection), palpation of lymph nodes in your neck/throat, and abdominal palpation to monitor possible spleen enlargement. Findings from these assessments plus reported symptoms will assist in developing a plan for treatment. College students often have a difficult time staying in their rooms and resting, but the health center will help in that process by communicating with professors and providing support therapy to ease the symptoms. Students can contact professors and develop a plan to keep up with classes while recuperating, and fellow students will be happy to bring work to you rather than having you come to class and possibly share the virus! One piece of good news is that if you have mono once, immunity is built up and the chance to get it again in the future is very low.

Signs and Symptoms of Mono

• Fatigue
• Sore throat that does not improve, even if antibiotics used
• Fever
• Swollen lymph nodes (neck, armpits)
• Swollen tonsils
• Headache
• Skin rash
• Soft, swollen spleen

Give us a call at the health center with any concerns, and we’ll help you through your illness.

Mayo Clinic Mononucleosis