Effects

• Mononucleosis most commonly causes a very painful sore throat, swollen lymph nodes, fever and fatigue. It can also cause abdominal pain, particularly if the spleen or liver is inflamed as a result of the infection. In rare cases, mononucleosis interferes with breathing due to severe inflammation of the tonsils and throat.
  
  

Identification

• Diagnosis is made based on a combination of the patient's symptoms and test results. Several tests may be performed to confirm a suspected case of mononucleosis. The most commonly performed tests include a complete blood count (CBC), liver function test, and a heterophile antibody test. A high white blood cell count, elevated liver enzymes, and a positive antibody test are highly suggestive of mononucleosis, especially when the patient is a teenager or young adult.
  
  

Warning

• Although complications from mononucleosis are uncommon, in some cases they may be life-threatening. The most common severe complication to result from mononucleosis is a ruptured spleen. This usually occurs when the patient has begun to recover and resumes normal activity; the spleen, which is swollen from the disease process, can be ruptured if the patient participates in strenuous activities. Airway obstruction occasionally occurs if the tissues of the throat are unusually swollen; this leads to difficulty breathing or an inability to breathe and if left untreated can rapidly lead to death.
  
  

Prevention/Solution

• There is no specific treatment for mononucleosis other than supportive care. Patients with mononucleosis are generally advised to get plenty of rest, drink lots of fluids, and take over-the-counter pain medication to alleviate discomfort. Occasionally, corticosteroids such as prednisone are required if the throat is extensively swollen. Mononucleosis can be transmitted for a long period of time, possibly months, after symptoms are no longer present. During this time frame, it is important to avoid kissing and sharing anything that could be contaminated by saliva so that others do not become ill.
  
  

Time Frame

• Mononucleosis symptoms typically last for three to four weeks, although in rare cases the illness may last much longer. Once the symptoms are no longer present, it is important to avoid sports, rough play, and other strenuous activities for at least another month. Antibodies to the Epstein-Barr virus are present for life and prevent future re-infection.