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Disease: Mononucleosis Mononucleosis
Category: Blood diseases & tumors
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Disease Definition:

Kissing disease is what we often call infectious mononucleosis (mono). People can get the virus that causes mono through kissing, as this virus is transmitted through saliva, however a person can be exposed to this virus by sharing a glass or food utensil with someone who has mono, or through a sneeze or cough.

Young adults and adolescents are most likely to get mononucleosis with all its signs and symptoms. The infection often goes unrecognized in young children as they usually have few symptoms.

The key to recovery is adequate fluids and rest. People who have mononucleosis should be especially careful of certain complications such as an enlarged spleen.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


The following are the signs and symptoms of mononucleosis:


  • Swollen tonsils
  • Fatigue
  • Fever
  • Swollen lymph nodes in the neck and armpits
  • Headache
  • Night sweats
  • Sore throat, perhaps a strep throat that doesn't get better with antibiotics
  • Weakness
  • Loss of appetite
  • Skin rash
  • Soft, swollen spleen

Although in young children the period of incubation is shorter, the virus typically has an incubation period of 4 to 8 weeks. Although a swollen spleen, fatigue and enlarged lymph nodes may last for a few weeks longer; the sore throat and fever usually lessen within a couple of weeks.

Someone may have mononucleosis when experiencing the above symptoms. This person should see a doctor if his/her symptoms recur or if healthy diet and rest don't ease them within a week or two. 


The Epstein-Barr virus is the cause of mononucleosis despite the fact that cytomegalovirus may cause similar signs and symptoms.  

Most adults have been exposed to the Epstein-Barr virus and have built up antibodies; being immune, they won’t develop mononucleosis again. So usually, mononucleosis isn't very serious.



Enlargement of the spleen is among the significant complications of mononucleosis. Causing sharp, sudden pain in the left side of the upper abdomen, the spleen may rupture in extreme cases. The patient may need surgery, and if such pain occurs, medical attention should be sought immediately.  

The following are problems with the liver that may occur:

Usually in people older than 35, a yellowing of the skin and the whites of the eyes occurs in some cases.

Mild liver inflammation (hepatitis) may be experienced as well.

The following less common complications may be the result of mononucleosis as well:


  • Inflammation of the heart
  • Swollen tonsils, leading to obstructed breathing
  • Anemia, a condition in which there’s a decrease in red blood cells and in hemoglobin, an iron-rich protein in red blood cells
  • Guillain-Barre syndrome, meningitis, encephalitis, or other complications that involve the nervous system.  
  • Thrombocytopenia — low count of platelets, which are blood cells involved in clotting

In people who have impaired immune systems, such as people taking drugs to suppress immunity after an organ transplant or people with HIV/AIDS, the Epstein-Barr virus can causes much more serious illness.


Antibiotics don't work against viral infections such as mono. Adequate fluid intake and bed rest are mainly involved in treatment. So there's no specific therapy available to treat infectious mononucleosis.

Risk of rash with some medications:
Though it doesn't mean that they're allergic to the antibiotic, some people with mononucleosis who take amoxicillin, amoxicillin and clavulanate or ampicillin may develop a rash. To treat infections that may accompany mononucleosis, other antibiotics that are less likely to cause a rash are available if needed.

Treating secondary infections:
The sore throat of mononucleosis is occasionally accompanied by a streptococcal (strep) infection. A person may develop an infection of the tonsils (tonsillitis) or a sinus infection as well. For these accompanying bacterial infections, one may need treatment with antibiotics.

A corticosteroid medication such as prednisone may be prescribed to ease some of the symptoms, such as severe swelling of the throat and tonsils.


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