Learn About Mononucleosis
Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.
Mono; Kissing disease; Glandular fever
Mono is often spread by saliva and close contact. It is known as "the kissing disease." Mono occurs most often or seen in adolescents and young adults, but the infection may develop at any age.
Mono is caused by the Epstein-Barr virus (EBV). Rarely, it is caused by other viruses, such as cytomegalovirus (CMV).
Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. Often, the lymph nodes in the neck are swollen and painful.
A pink, measles-like rash can occur, and is more likely if you take the medicine ampicillin or amoxicillin for a throat infection. (Antibiotics should typically not given without a test that shows you have a strep infection.)
Common symptoms of mono include:
- Drowsiness
- Fever
- General discomfort, uneasiness, or ill feeling
- Loss of appetite
- Muscle aches or stiffness
- Rash
- Sore throat
- Swollen lymph nodes, most often in the neck and armpit
Less common symptoms are:
- Chest pain
- Cough
- Fatigue
- Headache
- Hives
- Jaundice (yellow color to the skin and whites of the eyes)
- Neck stiffness
- Nosebleed
- Rapid heart rate
- Sensitivity to light
- Shortness of breath
The goal of treatment is to relieve symptoms. Steroid medicine (prednisone) may be given if your symptoms are severe.
Antiviral drugs, such as acyclovir, have little or no benefit.
To relieve typical symptoms:
- Drink plenty of fluids.
- Gargle with warm salt water to ease a sore throat.
- Get plenty of rest.
- Take acetaminophen or ibuprofen for pain and fever.
Also avoid contact sports if your spleen is swollen (to prevent it from rupturing).
Hiroshi Kimura practices in Fukushima, Japan. Mr. Kimura is rated as an Elite expert by MediFind in the treatment of Mononucleosis. His top areas of expertise are Mononucleosis, Hemophagocytic Lymphohistiocytosis, Non-Langerhans-Cell Histiocytosis, Bone Marrow Aspiration, and Glossectomy.
Tim Waterboer practices in Heidelberg, Germany. Mr. Waterboer is rated as an Elite expert by MediFind in the treatment of Mononucleosis. His top areas of expertise are Human Papillomavirus Infection, Mononucleosis, Helicobacter Pylori Infection, Squamous Cell Skin Carcinoma, and Tissue Biopsy.
Christian Munz practices in Zurich, Switzerland. Mr. Munz is rated as an Elite expert by MediFind in the treatment of Mononucleosis. His top areas of expertise are Mononucleosis, Burkitt Lymphoma, Kaposi Sarcoma, and Cytomegalovirus Infection.
The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Tiredness usually goes away within a few weeks, but it may linger for 2 to 3 months. Nearly everyone recovers completely.
Complications of mononucleosis may include:
- Anemia, which occurs when red blood cells in the blood die sooner than normal (hemolytic anemia)
- Hepatitis with jaundice (more common in people older than 35)
- Swollen or inflamed testicles
- Nervous system problems (rare), such as Guillain-Barré syndrome, meningitis, seizures, damage to the nerve that controls movement of the muscles in the face (Bell palsy), and uncoordinated movements
- Spleen rupture (rare, avoid pressure on the spleen)
- Skin rash (uncommon)
Death is possible in people who have a weakened immune system.
The early symptoms of mono feel very much like any other illness caused by a virus. You do not need to contact a provider unless your symptoms last longer than 10 days or you develop:
- Abdominal pain
- Breathing difficulty
- Persistent high fevers (more than 101.5°F or 38.6°C)
- Severe headache
- Severe sore throat or swollen tonsils
- Weakness in your arms or legs
- Yellow color in your eyes or skin
Call 911 or the local emergency number or go to an emergency room if you develop:
- Sharp, sudden, severe abdominal pain
- Stiff neck or severe weakness
- Trouble swallowing or breathing
People with mono may be contagious while they have symptoms and for up to a few months afterwards. How long someone with the disease is contagious varies. The virus can live for several hours outside the body. Avoid kissing or sharing utensils if you or someone close to you has mono.
Summary: Epstein Barr virus (EBV) is a virus which can cause infectious mononucleosis and is associated with certain kinds of cancer and multiple sclerosis. Researchers are looking for new ways to prevent disease related to EBV and have developed a new study vaccine (V350A and V350B). The main goal of this study is to learn about the safety and tolerability of V350A and V350B in healthy adults.
Summary: This study is for patients that have a type of lymph gland disease called Hodgkin or non-Hodgkin Lymphoma or T/NK-lymphoproliferative disease which has come back or has not gone away after treatment, including the best treatment the investigators know for these diseases. Some patients with Lymphoma or T/NK-lymphoproliferative disease show signs of virus that is sometimes called Epstein Barr virus ...
Published Date: March 16, 2024
Published By: Jatin M. Vyas, MD, PhD, Roy and Diana Vagelos Professor in Medicine, Columbia University Vagelos College of Physicians and Surgeons, Division of Infectious Diseases, Department of Medicine, New York, NY. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Ebell MH, Call M, Shinholser J, Gardner J. Does this patient have infectious mononucleosis?: the rational clinical examination systematic review. JAMA. 2016;315(14):1502-1509. PMID: 27115266 pubmed.ncbi.nlm.nih.gov/27115266/.
Johannsen EC, Kaye KM. Epstein-Barr virus (infectious mononucleosis, Epstein-Barr virus-associated malignant diseases, and other diseases). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 138.
Schooley RD, Allen UD. Epstein-Barr virus infection. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 348.
Stillwell TL, Weinberg JB. Epstein-Barr virus. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 301.