Mononucleosis – The Kissing Disease

shutterstock_52284313Contrary to the name, this isn’t a type of disease that you actually want to catch.  It’s an infection that causes symptoms including fever, sore throat, enlarged lymph nodes (often in the neck), and fatigue.  It’s more common in young adults than younger kids to the elderly.  Most of the time, it’s not a serious illness but it can lead to being out of school or work for a significant amount of time due to extreme fatigue.

Causes:  The infection is caused by Epstein-Barr Virus (EBV) and can be spread from one person to another by kissing, drinking from a glass of an infected person or sharing eating utensils.  Young children who are infected with EBV usually don’t develop symptoms like young adults.

Symptoms:  The most common symptoms of mono can take 4-8 weeks after exposure to develop and may be:

1)   Sore throat

2)   Enlarged lymph nodes in the neck

3)   Fever greater than 100.4 degrees F (38 degrees C)

4)   Fatigue that can last for several months

Complications:  The most worrisome problem that can occur after having mononucleosis is enlargement of the spleen.  Actually, it’s the increased chance of rupturing the spleen after accidentally falling on it during an activity or sports event that is the problem.  Normally the spleen is somewhat protected under the left rib cage and is not usually exposed.  It can become enlarged about 50% of the time after having mono, so we usually recommend avoiding sports activities or heavy lifting that might risk trauma to the spleen to those who have been diagnosed with mononucleosis.

Diagnosis:  The diagnosis is usually suspected based a physical examination of the patient, however a blood test can be done to confirm the diagnosis.

Treatment:  Since the infection is due to a virus, antibiotics are not useful to treat the illness.  The goal is to reduce the unpleasant symptoms and allow the immune system to heal the body.

Return to work/school:  I usually recommend going back to work or school after you have not had a fever for 24 hours.  An enlarged spleen due to the infection can take a few weeks to return to normal.  During this time the patient should not participate in activities that risk rupturing the spleen such as playing contact sports, or anything that put you at risk for falling.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.


I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO



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