Infectious mononucleosis, also known as mono, is a contagious viral disease.
Because of its prevalence in teenagers and young adults, it’s also sometimes called “the kissing disease.”
The Epstein-Barr virus (EBV) is the most common cause of mononucleosis.
Although most people get infected with EBV in their lifetime, not everyone develops symptoms of mono. When symptoms do appear, they can usually be monitored and cared for at home.
In some cases, symptoms of mono can persist for several weeks or months.
While these symptoms can cause discomfort and disrupt daily life, they are very rarely life threatening. However, complications of the disease are possible.
In this article, we’ll explore the symptoms, diagnosis, and treatment of mononucleosis and when the infection can cause more serious or life-threatening complications.
What Is Mono?
Infectious mononucleosis is a contagious viral disease.
It is most commonly spread through saliva but can also be spread through other bodily fluids, like blood, semen, and mucus.
Though the infection is most common in people 15-35 years of age, a person of any age can get mono.
Symptoms
Not everyone exposed to the viruses that cause mono will develop symptoms.
But when symptoms do occur, they can take four to six weeks to appear.
In most cases, symptoms develop slowly.
Common symptoms of mono include:
Fatigue or a general ill feeling
Muscle aches or stiffness
Swollen tonsils that sometimes develop whitish-yellow patches
Swollen lymph nodes that can sometimes feel painful
Other less common symptoms are also possible:
Yellowing of the skin and whites of the eyes
Neck stiffness
Rapid heart rate
Enlarged spleen
Swollen liver
For people who develop symptoms, it can take several weeks for symptoms to resolve. But in some cases, symptoms can persist for six months or longer.
Diagnosis
Most providers are able to diagnose mono based on your symptoms and a physical examination of your lymph nodes, tonsils, skin, and/or spleen.
Though laboratory tests are not usually needed to diagnose the infection, your provider may recommend certain tests if your symptoms are atypical.
Examples of blood tests that can be used to diagnose mono include:
White blood cell count test (WBC)
Monospot test
Antibody test
Treatment
In most cases, treatment of mono is focused on relieving symptoms.
This may include:
Drinking plenty of fluids
Resting
Gargling with salt water to soothe a sore throat
Using over-the-counter (OTC) pain relievers (like acetaminophen or ibuprofen) if needed
Antibiotics will not help mono, and antiviral medications like acyclovir are also unlikely to provide relief.
But in severe cases, your provider may recommend a prescription steroid medication, like prednisone.
Causes
The most common cause of mono is the Epstein-Barr virus.
In rare cases, it can be caused by other viruses and infections, such as:
Cytomegalovirus (CMV)
Toxoplasmosis
HIV
Rubella
Hepatitis A, B, or C
Adenovirus
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Can You Die From Mono?
Healthy individuals are very unlikely to die from mononucleosis.
But for people with weakened immune systems, mono can pose a more serious threat.
If you’re immunocompromised, it’s important to speak with your healthcare provider about a safe treatment plan for a suspected or diagnosed case of mono.
Mono complications
Mono can cause complications, including an enlarged liver and/or spleen, in some people.
It can take several weeks or months for your spleen or liver to recover after infection.
In the meantime, it’s important to avoid alcohol and contact sports, the latter of which could cause your spleen to rupture.
Other complications of mono are possible.
They include:
Hepatitis with jaundice
Swollen or inflamed testicles
Guillain-Barré syndrome
Seizures
Bell palsy
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When to See a Doctor
Mono can cause a wide range of symptoms, which can make it difficult to diagnose in its early stages.
If you’re experiencing any symptoms of mono (including fever, fatigue, or weakness) that last for 10 days or longer, reach out to your healthcare provider.
Diagnosing mono early can help you limit the spread to other people and begin treatments that soothe your symptoms as soon as possible.
If you experience any of the following severe symptoms, go to the nearest emergency room or seek immediate medical attention:
Sharp, sudden, and/or severe abdominal pain
Stiff neck
Severe weakness
Trouble swallowing or breathing
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