Top 6 Treatments for Infectious Mononucleosis

Diagnosis Based on Clinical Symptoms and Signs

The diagnosis of infectious mononucleosis is based on typical symptoms and signs, including:

• Allergic pharyngitis: can be severe, painful, sweating, and may resemble Streptococcal pharyngitis
• Fever: typically high in the afternoon or evening, with temperatures around 39.5°C and can reach 40.5°C
• Enlarged lymph nodes: usually symmetrical, involving any group of nodes, especially the anterior and posterior cervical chains
• Seizures
• Enlarged liver with tenderness
• Periorbital and palatal edema
• Rarely, rash appearance
• Splenomegaly: occurring in about 50% of cases

Diagnosis Based on Paraclinical Tests

Paraclinical tests used in diagnosing infectious mononucleosis include:

• Heterophile antibody test: measured using various agglutination tests. However, only about 50% of patients with the disease have heterophile antibodies, and around 80-90% of adolescents and adults with infectious mononucleosis will have them. Additionally, heterophile antibody tests can yield false positives in patients with acute HIV infection, with antibody levels increasing in the second and third weeks of illness. Therefore, if the diagnosis is uncertain but the heterophile antibody test is negative, it should be repeated after 7-10 days.
• EBV serology: the presence of IgM antibodies to the virus’s surface antigen indicates primary EBV infection, but these antibodies persist for life. EBV nuclear antigen antibodies develop later in acute EBV infection and also persist for life. If EBV antibody titers are negative or if the infection appears to be chronic, additional testing may be necessary.

Currently, there is no specific treatment for infectious mononucleosis. Antibiotics are not used for viral infections. Therefore, the primary treatment is supportive to help the body recover naturally. Key recommendations include adequate rest, a healthy diet, and staying hydrated. If you experience fever and pain, over-the-counter pain relievers and fever reducers may be helpful.

Drug Treatment:

• Secondary Infection Treatment: Sometimes, bacterial pharyngitis may occur alongside infectious mononucleosis. If you have sinusitis or tonsillitis, antibiotic treatment may be necessary.
• Risk of Rash from Certain Medications: Drugs like amoxicillin or penicillin should be avoided as they can cause rashes. Therefore, patients with infectious mononucleosis should refrain from using specific antibiotics known to trigger rash formation.

Here are some tips for you:

• Drink plenty of water and fruit juices. Staying hydrated helps reduce fever and prevents dehydration.
• Use over-the-counter pain relievers appropriately. Medications such as acetaminophen or ibuprofen can effectively reduce pain and fever. However, avoid giving aspirin to young children.
• Gargle with salt water. Do this several times a day to soothe a sore throat. Mix about ½ teaspoon of salt in 200 ml of water for gargling.

Additionally, limit physical activity and exertion. Most symptoms will subside within a few weeks, but some may linger for several months before you fully recover. The more you rest, the shorter your recovery time will be. If you resume physical activity too soon, you may increase the risk of relapse.

To avoid spleen rupture, your doctor may advise you to wait about a month before engaging in strenuous activity. Lifting heavy objects or exercising too soon can cause spleen rupture if you haven't fully recovered. Spleen rupture is very dangerous, so be cautious about this.

Infectious mononucleosis refers to a collection of symptoms caused by the Epstein-Barr virus (EBV). This virus primarily spreads through saliva from an infected person, or through coughing, sneezing, kissing, and sharing food. It is not transmitted through blood.

Infectious mononucleosis is not easily spread; the virus is less contagious than the common flu. It mainly affects teenagers and young adults, but children can also contract the virus, though symptoms may be mild.

If you are unfortunate enough to contract the illness, the most important aspect is preventing complications. Treatment is relatively simple, involving rest and hydration.

Infectious mononucleosis typically manifests 4 to 8 weeks after infection with symptoms such as:

• Fever and sore throat
• Signs of toxicity like fatigue, loss of appetite, and muscle pain in the early stages
• Enlarged lymph nodes that are non-fixed, mildly tender, and not filled with pus
• Enlarged spleen
• Rash with papular or petechial characteristics
• Virus causing pharyngitis, tonsillitis, gingivitis, and hemorrhagic spots in the mouth
• CNS damage such as peripheral facial nerve palsy, respiratory symptoms like cough, shortness of breath, and airway obstruction
• Rapid heart rate, arrhythmia
• Hepatitis; kidney failure due to interstitial nephritis

The virus has an incubation period of 4-6 weeks. However, in children, this period may be shorter. Symptoms like sore throat and fever often subside within a couple of weeks. However, fatigue and spleen enlargement may persist for longer periods. If you experience any of these symptoms, you may have infectious mononucleosis. If symptoms do not subside within 1 to 2 weeks, consult a doctor.

In most cases, infectious mononucleosis is not serious and can be easily treated. However, if not properly managed, complications can arise and worsen. Below are some potential complications to be aware of:

Enlarged Spleen
Infectious mononucleosis can cause the spleen to enlarge. In severe cases, the spleen may rupture, causing a sharp, intense pain in the left side of the abdomen. If you experience this kind of pain, seek emergency medical attention immediately, as it can be life-threatening and may require emergency surgery.

Liver Complications
Several issues with the liver may occur, including:

• Hepatitis
• Jaundice (yellowing of the skin and eyes)

Less Common Complications
Some rare complications that may occur include:

• Anemia
• Low platelet count
• Heart complications: Inflammation of the heart muscle, a condition known as myocarditis
• Neurological complications: Meningitis, encephalitis, and Guillain-Barre syndrome may develop
• Swollen Tonsils: If the tonsils become too swollen, it could lead to difficulty breathing

For individuals with weakened immune systems, the Epstein-Barr virus can cause severe illness. High-risk groups include people with HIV/AIDS or those who have undergone organ transplants and are on immunosuppressive drugs.