Infectious Mononucleosis (Mono) - Treatments

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What is the usual course and treatment of mono?

In most cases of mono, no specific treatment is necessary. The illness is usually self-limited and passes much the way other common viral illnesses resolve. Treatment is directed toward the relief of symptoms. Available antiviral drugs have no significant effect on the overall outcome of mono and may actually prolong the course of the illness. Occasionally, Strep throat occurs in conjunction with mono and is best treated with penicillin or erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone). Ampicillin (Omnipen, Polycillin, Principen) and amoxicillin (Amoxil, DisperMox, Trimox) should be avoided if there is a possibility of mono since up to 90% of patients with mono develop a rash when taking these medications. They may then be inappropriately thought to have an allergy to penicillin.

For the most part, supportive or comfort measures are all that is necessary. Acetaminophen (Tylenol) can be given for fever and any headache or body aches. A sufficient amount of sleep and rest is important. The throat soreness is worst during the first five to seven days of illness and then subsides over the next seven to 10 days. The swollen, tender lymph nodes generally subside by the third week.

A feeling of fatigue or tiredness may persist for months following the acute phase of the illness. It is recommended that patients with mono avoid participation in any contact sports for three to four weeks after the onset of symptoms to prevent trauma to the enlarged spleen. The enlarged spleen is susceptible to rupture, which can be life threatening. Cortisone medication is occasionally given for the treatment of severely swollen tonsils or throat tissues which threaten to obstruct breathing.

Patients can continue to have virus particles present in their saliva for as long as 18 months after the initial infection. When symptoms persist for more than six months, the condition is frequently called "chronic" EBV infection. However, laboratory tests generally cannot confirm continued active EBV infection in people with "chronic" EBV infection.

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See what others are saying

Comment from: twoblackkatz, 55-64 Female (Patient) Published: November 30

I am 58 and was diagnosed with mono almost a month ago, I was tired and had headaches for about a month before finally going in for blood work. Now my muscles are burning and I am having muscle spasms. My 25 year old daughter has it now and has a bad case of pharyngitis and ear infections, she's much sicker than me, I feel so bad she's so miserable. Thought I was over it and over did it a couple of days and feel sick again so make sure you get lots of rest and don't rush it.

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Comment from: Kristibaby, 25-34 Female (Patient) Published: March 20

I was extremely fatigue. I could even stand or sit up to take a shower. I was very very weak and always tired and night sweats. It was the worst feelings I have ever felt. I knew something was wrong. It took me almost a month to get back to normal. The doctor prescribed iron pills to produce more cells. I was about 19 at the time when it happened. I believe I got mono from drinking off my girlfriend's cup who had mono. That's how I knew I had it because she said she just was getting over mono. Ever since I am always really tired and weak.

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