When Mono Takes You Out of the Action (cont.)

For fever and achiness, you can take acetaminophen (marketed as Tylenol, Datril and others) or ibuprofen (marketed as Advil, Motrin, Nuprin, and others). If you're under 20, don't take aspirin unless your doctor approves it. In children and teens, aspirin taken for viral illnesses has been associated with the potentially fatal disease Reye syndrome. Sometimes a person with mono may have trouble breathing because of swelling in the throat, and doctors have to use other medications and treatment. A person who has mono -- or those caring for the person -- should contact a doctor immediately if the person starts having breathing problems.

Some people with mono become overly sensitive to light and about half develop enlargement of the spleen, usually two to three weeks after they first become sick. Mild enlargement of the liver may also occur.

Whether or not the spleen is enlarged, people who have mono should not lift heavy objects or exercise vigorously -- including participating in contact sports -- for two months after they get sick, because these activities increase the risk of rupturing the spleen, which can be life-threatening. If you have mono and get a severe sharp, sudden pain on the left side of your upper abdomen, go to an emergency room or call 911 immediately.

Because its symptoms can be very similar to those of other illnesses, doctors often recommend tests to find out exactly what the problem is.

"I was misdiagnosed at first and told I was bit by a spider," writes John L. Gipson, of Kansas City, Mo., in a note he posted to a Website. "That's what I thought because I had killed a spider in my room. I figured I'd been bitten by a spider in my sleep. A few days after...I had no energy, a fever...and those pea-sized bumps on the back of my neck." Gipson returned to his doctor, who did blood tests and diagnosed mononucleosis.

Other diagnostic problems can result because enlarged lymphocytes, a type of white cell, are common with mono, but can also be a symptom of leukemia. Blood tests can distinguish between the type of white cell seen in leukemia and that with mono.

If your throat is sore, having a throat culture is usually a good idea for several reasons. First, the symptoms of mono and strep infection (including that caused by Strep-A, a particularly serious form of strep) are very similar. Second, strep throat or other throat infections can develop anytime during or shortly after in the disease. In any case, it's important that throat infections be diagnosed as soon as possible and treated with antibiotics that can kill the organism responsible for the infection.

The test most commonly used to tell whether you have mono or some other ailment is the mononucleosis spot test. This blood test detects the antibodies (proteins) that the body makes to fight EBV or CMV. Because it takes a while for antibodies to develop after infection, your doctor may need to order or repeat the test one to two weeks after you develop symptoms. At that time the test is about 85 percent accurate.

Other tests your doctor might order include a complete blood count (CBC) to see if your blood platelet count is lower than normal and if lymphocytes are abnormal, and a chemistry panel to see if liver enzymes are abnormal.

Bed rest is the most important treatment for uncomplicated mono. It's also important to drink plenty of fluids. Mono is not usually a reason to quarantine students. Many people are already immune to the viruses that cause it. But if you have mono you'll want to stay in bed and out of classes for several days, until the fever goes down and other symptoms abate. Even when you've started to get better, you can expect to have to curtail your activities for several weeks, and it can take two to three months or more until you feel your old self again.

The author of this article had mono herself when she was 16. Though she didn't mind getting out of all that homework (or at least putting it off), having to delay finals only added to her anxiety about college applications that many high school juniors experience. And then there was that guy who never called again.

When you add the time spent recuperating to the fact that most people are not exactly anxious to get close to a person with mono, you can understand why some students find themselves combating loneliness on top of their other troubles.

Getting through mono may be both challenging and depressing -- and seem to take forever. But if you rest when your body tells you to, you can lessen the chances of complications and get back your life.

Souce: U.S. Food and Drug Administrations

Last Editorial Review: 4/21/2008