Medication
So a common treatment plan for mono is rest with a gradual return to normal activity. The goal is to ease your symptoms and treat any complications that happen. In addition to rest, your doctor may prescribe ibuprofen or acetaminophen for the fever, sore throat, and other discomforts of the illness.
Procedures
Outlook / Prognosis What is the prognosis (outlook) for people with mononucleosis (mono)? Mono symptoms can be severe. They may temporarily affect your ability to lead an active life. Fortunately, these symptoms gradually improve with at-home treatments. You may experience lingering fatigue for several months.
Self-care
Your doctor is likely to ask you a number of questions, including: 1 When did you develop symptoms? 2 Have you been exposed to anyone with mononucleosis? 3 Have your symptoms been continuous or occasional? 4 How severe are your symptoms? 5 What, if anything, seems to improve your symptoms? 6 What, if anything, appears to worsen your symptoms?
Nutrition
How can mononucleosis be prevented? Infectious mononucleosis can be prevented by limiting oral and sexual contacts, as the most common mode of EBV transmission is contact with saliva. Other methods of prevention include hand washing and avoiding shared utensils or cups within a household.
What are the treatment options for mono?
What is the prognosis of mononucleosis (mono)?
What questions should I ask my doctor about my mononucleosis symptoms?
How can mononucleosis be prevented?
What is the treatment plan for infectious mononucleosis?
There's no specific therapy available to treat infectious mononucleosis. Antibiotics don't work against viral infections such as mono. Treatment mainly involves taking care of yourself, such as getting enough rest, eating a healthy diet and drinking plenty of fluids.
What laboratory testing is commonly done when mono is suspected?
Monospot test. This test looks for specific antibodies in the blood. These antibodies show up during or after during certain infections, including mono.
How is mono and strep treated?
If your throat is very sore or if your tonsils are swollen, your doctor might prescribe medicines called corticosteroids. Because mono is caused by a virus, antibiotics would not help you get better. But some people with mono get strep throat at the same time. Antibiotics will help strep throat go away.
What are the laboratory findings in a patient who has mononucleosis?
Findings consistent with infectious mononucleosis include a differential that demonstrates greater than 50% lymphocytes, an absolute lymphocyte count greater than 4500, or an elevated lymphocyte count with greater than 10% atypical lymphocytes.
Which test is most specific for infectious mononucleosis?
Tests for antibodies to Epstein-Barr viral capsid antigen or Epstein-Barr nuclear antigen are the most sensitive, are highly specific, and are also the most expensive for diagnosing infectious mononucleosis (strength of recommendation [SOR]: C, based on validating cohort study).
How is mononucleosis diagnosed?
Mono may be suspected based upon a person's symptoms and physical examination. Blood tests are done to confirm the diagnosis. However, the most commonly used blood test for diagnosis in North America, known as the Monospot, can be falsely negative during the first weeks of symptoms.
How can you prevent mononucleosis?
Prevention. Mononucleosis is spread through saliva. If you're infected, you can help prevent spreading the virus to others by not kissing them and by not sharing food, dishes, glasses and utensils until several days after your fever has improved — and even longer, if possible.
How is Epstein-Barr treated?
Although no medicine can cure an EBV infection, you can take these steps at home to ease your symptoms:Get plenty of rest.Drink a lot of water and other liquids to stay hydrated.Suck on lozenges or ice pops, or gargle with warm salt water, to make your sore throat feel better.More items...•
Is it possible to have mono and strep at the same time?
Because mono is caused by a virus, antibiotics would not help you get better. But some people with mono get strep throat at the same time. Antibiotics will help strep throat go away.
What labs are elevated with Epstein Barr?
People are considered to have a primary EBV infection if they have anti-VCA IgM but do not have antibody to EBNA. Other results that strongly suggest a primary infection are a high or rising level of anti-VCA IgG and no antibody to EBNA after at least four weeks of illness.
Which tests are most specific for the diagnosis of IM?
A heterophile antibody test is the best initial test for diagnosis of EBV infection, with 71% to 90% accuracy for diagnosing IM.
Why was a Monospot test ordered?
A mononucleosis spot (or Monospot) test is a blood test used to determine whether you have contracted the Epstein-Barr virus, the virus that causes infectious mononucleosis. Your doctor may order this test if you have symptoms of mononucleosis.
How common is mono?
The Epstein-Barr virus (EBV) that causes mono is extremely common. Around 90% of Americans are infected with it by age 35. Not everyone who has the virus develops mono symptoms — some people only carry the virus.
How long does mono last?
Symptoms of mono vary, and they can be mild or severe. They tend to come on gradually. If you get sick with mono, it will probably happen four to six weeks after you come in contact with EBV. These symptoms may last for four weeks or longer: Enlarged spleen or liver. Extreme fatigue.
Why is mono called the kissing disease?
Mono is sometimes called “the kissing disease” because it spreads easily through bodily fluids like saliva. For most people, mono isn’t serious, and it improves without treatment. Still, extreme fatigue, body aches and other symptoms can interfere with school, work and daily life.
What is the best medicine for enlarged spleen?
These drugs include ibuprofen (Advil®) and naproxen (Aleve®). Acetaminophen (Tylenol®) also works. Sore throat soothers: You can gargle with salt water and use throat lozenges. Avoiding sports: Physical activity can put too much pressure on an enlarged spleen, increasing the risk of rupture.
Does mono work against other viruses?
Antibiotics to fight bacterial infection and antiviral medications to kill other viruses don’t work against mono. Instead, treatments focus on helping you feel better by relieving symptoms. Your care might include: Rest: Mono makes you very tired. Sleep helps your body fight infection.
Can mono cause spleen bleed?
This gland in the upper left abdomen (belly) helps filter blood. If your spleen bursts, it can bleed into your abdomen.
Can mononucleosis cause a sore throat?
Most cases of mononucleosis (mono) don’t cause serious problems. However, symptoms like extreme fatigue, sore throat and body aches can disrupt school, work and life. Your healthcare provider can provide suggestions for finding relief. Rest and over-the-counter medications are often the best ways to ease symptoms.
How long does it take to recover from mononucleosis?
Most people start to recover from mononucleosis within 2 weeks, though some symptoms, such as fatigue, can take 3-4 weeks or even longer to go away. So a common treatment plan for mono is rest with a gradual return to normal activity. The goal is to ease your symptoms and treat any complications that happen.
How long does it take for a monospot test to show antibodies?
This test isn’t always accurate, especially in younger children, and it takes several days for it to show the presence of the antibodies after a child starts to feel ill. The “monospot” is one test that checks for heterophile antibodies. The results of these tests are not always clear, so you may need even more tests.
Can you take aspirin with mono?
In case mono has affected your liver, check with your doctor before you take acetaminophen. Don’t give aspirin to children or teens. It’s been linked to a disease called Reye's syndrome, a serious illness that can be life-threatening. Call 911 if you or your child is having any trouble breathing.
Can you get an EBV test for mono?
You may also get an EBV test if you don’t seem to have a typical case of mono. This blood test checks for Epstein Barr virus. Doctors usually don’ t need EBV test results to diagnose mono. But it can help them find out if the Epstein Barr virus is to blame.
Context
Infectious mononucleosis (IM) typically occurs between the ages of 15-24 (most often at 16-20 years).
Quality Of Evidence?
We are highly confident that the true effect lies close to that of the estimate of the effect. There is a wide range of studies included in the analyses with no major limitations, there is little variation between studies, and the summary estimate has a narrow confidence interval.
RESOURCE AUTHOR (S)
The purpose of this document is to provide health care professionals with key facts and recommendations for the diagnosis and treatment of patients in the emergency department. This summary was produced by the BC Emergency Medicine Network and uses the best available knowledge at the time of publication.
What is the recommended test for mononucleosis?
Recommended testing includes not only confirmatory testing for EBV (V CA IgM and IgG, EBNA), but also testing to rule out other pathogens that can present with mononucleosis-like syndromes, such as CMV, HIV, toxoplasma gondii, and HHV6.
What is the cause of mononucleosis?
Toxoplasma gondii is a protozoan that can cause a mononucleosis syndrome in immunocompetent individuals. It is well known for causing disease through human contact with cat feces, as well as causing ring-enhancing lesions in the central nervous system (CNS) in AIDS patients. Its life cycle is completed in the feline intestinal tract, with oocysts shed in cat feces. In addition, in many parts of the world, people are infected through ingestion of cysts from undercooked meat. Diagnosis is especially important in pregnant women, as it can cause a congenital syndrome characterized by damage to the fetal nervous system. Serology is not particularly useful, as IgM can persist for years after acute infection. IgG avidity testing or DNA PCR should be used instead.
What are the similarities between mononucleosis and lymphadenopathy?
Major similarities to infectious mononucleosis. Disease in immunocompetent hosts can cause lymphadenopathy (generally cervical or occipital), constitutional symptoms, maculopapular rash, pharyngitis, and hepatosplenomegaly. Atypical lymphocytes may be present.
What is the primary mode of transmission of mononucleosis?
Common modes of transmission. Mononucleosis is known as the “kissing disease”. The primary mode of transmission is by saliva. Transmission among siblings is common due to close contact, sharing cups and utensils, etc.
Is EBV asymptomatic or subclinical?
In an affluent/developing country, such as the United States, EBV infection is often delayed into adolescence or even adulthood, resulting in infectious mononucleosis rather than the asymptomatic or subclinical presentation that occurs more often in childhood.
Is CMV a herpes virus?
CMV mononucleosis is estimated to comprise 7% of all infectious mononucleosis syndromes. Like EBV, it belongs to the herpes virus family, usually causes an asymptomatic infection early in life in most individuals, and then lies dormant and remains within the host for life. More than 80% of adults are seropositive.
Do steroids help with mononucleosis?
Steroids have not been shown to reduce symptoms of mononucleosis or time to resolution of symptoms. Improvement in sore throat has been demonstrated with oral dexamethasone at 12 hours in one emergency department based RCT in children, but this effect was lost at all later time points. In another small RCT, a 12-day taper of oral prednisone was shown to improve certain endpoints, including return to normothermia, decrease in white blood cell (WBC) count, and normalization of heterophil antibody titer, but all other endpoints were not significantly different from placebo.
What is the best treatment for IM?
Recommended therapy for management of IM has not changed much over the years. Pharmacologic options remain limited and mostly include symptomatic treatment or supportive care. Fever, myalgias, and throat discomfort can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. 2,8 Throat lozenges and sprays containing benzocaine or phenol along with prescription lidocaine 2% can be used for sore throat. 1,4
What is the most common test to exclude before diagnosis of IM?
Pharyngitis can be caused by various bacteria (e.g., group A streptococcus) and viruses (EBV, adenovirus, influenza, herpes simplex), so excluding these causes for symptoms may be pertinent. Throat culture testing for group A streptococcus is likely the most common test to exclude before diagnosis of IM.
Can EBV cause fatigue?
Young children infected with EBV generally are asymptomatic or have such mild disease that symptoms are not recognized. Older children, teens, and young adults are more likely to develop the symptomatic clinical signs of IM. Once infected, some patients may experience a prodromal period of symptoms where they may experience headache, anorexia, and fatigue for 1 to 2 weeks before more classical symptoms become apparent. 4
How to treat mononucleosis?
Mononucleosis is treated with rest, fluids, and over-the-counter medications that provide symptom relief. Over-the-counter pain relievers can help reduce fever, sore throat, and body aches. Over-the-counter throat lozenges can help with the sore throat.
What is the best pain reliever for mononucleosis?
Acetaminophen is the most commonly advised pain reliever for mononucleosis, but (nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, naproxen, or aspirin can also be used. Because of the risk of Reye’s syndrome, a potentially fatal drug reaction, aspirin should never be given to children or teenagers with a viral infection.
How to tell if you have monospot?
With a Monospot blood test, a general practitioner can arrive at a diagnosis in minutes. The common symptoms of infectious mononucleosis are fever, sore throat, swollen glands, and fatigue. Patients frequently describe the sore throat as the worst they’ve ever experienced. Other possible mono symptoms include:
Where does mononucleosis spread?
Also called glandular fever, infectious mononucleosis initially infects cells in the top of the mouth and throat and spreads to the salivary glands (tonsils). From there, the virus enters into B lymphocytes, a type of white blood cell responsible for fighting infections.
What is the cause of mononucleosis?
Several different viruses cause mononucleosis, but nine out of 10 cases are caused by the Epstein-Barr virus (EBV), a type of herpesvirus. Other cases are caused by cytomegalovirus (CMV), but rubella, adenovirus, hepatitis A, and others are also behind some infections. The virus is primarily spread through saliva.
Do people with mononucleosis reactivate?
Once infected, people carry the virus in a dormant stage for the remainder of their life and it usually does not reactivate. Infectious mononucleosis is most common among people never exposed to the virus, mainly teenagers, college students, and young adults.
Can you get mono from kissing?
They call mono the “kissing disease.”. Despite its reputation, not all people contract mononucleosis (mono) from kissing, but from activities like sharing a straw, using someone else’s toothbrush, or just standing in the way of someone else’s sneeze. Unfortunately, once mono has taken hold, there is no cure.
What is mononucleosis in adults?
Mononucleosis in Adults: What to Expect and How to Cope. [updated January 2020] Infectious Mononucleosis, or more commonly known as “Mono”, is a viral infection most commonly due to the Epstein-Barr virus (although it can be due to Cytomegalovirus (CMV) as well). In fact, the Epstein-Barr virus ...
Why is mono considered a disease?
Mono has the reputation for being the “Kissing Disease” because amongst the teenage and collegiate ages it is most commonly transmitted through saliva. A person can be exposed to the Epstein-Barr virus (EBV) by kissing, sharing eating utensils, or drinking from the same glass as a person who has mono.
Is mono a good thing?
Mono in Adults . Now, most adults, whether they ever developed full-blown Mononucleosis or never had any known symptoms, typically have protective antibodies to the Epstein-Barr virus. This is a good thing because if you have antibodies to the Epstein-Barr virus you should be immune to being infected and becoming sick.
Did Robin Soderling recover from Mono?
Fortunately, he was diagnosed and gave his body some extra time to recover. Robin Soderling, a Swedish top-ranked tennis player wasn’t as fortunate. He developed Mono and the fatigue he developed never improved and his tennis career was cut short in his early thirties: the prime of his career.
Can everyone get mono?
And not everyone who has the virus develops mono symptoms – many people only carry the virus. Most people get the virus as early school-age children or around adolescence/young adulthood; but, anyone can get it, no matter their age.
Do monos have the same symptoms as teens?
Unlike the youngsters, adults with Mono often don’t have the same presenting symptoms of an acute, severe sore throat and swollen lymph glands in the neck.
Can mono cause stomach pain?
Adults with Mono can experience chronic stomach pain and fatigue of insidious onset. The adult form of mononucleosis caused by the Epstein-Barr virus is different from the disease in children and adolescents.
Medicines
Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
Prevent the spread of mono
Do not share food or drinks. Do not kiss anyone. The virus may be in your saliva for several months after you feel better. Wash your hands often. Use soap and water. Wash your hands after you use the bathroom, change a child's diapers, or sneeze. Wash your hands before you prepare or eat food.
Follow up with your healthcare provider in 3 to 4 weeks
Write down your questions so you remember to ask them during your visits.
Further information
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