How serious is mono?

If you've ever had mono – short for infectious mononucleosis – you probably remember its classic symptoms well: exhaustion, malaise, sore throat and fever. While these can be a nuisance, is getting mono serious? We sat down with John Bigler, DO, family medicine, HonorHealth Medical Group - Arcadia - Primary Care, to learn more.

What is mono?

Mono is an illness most often caused by the Epstein-Barr virus. However, other viruses, including cytomegalovirus, HIV and toxoplasma, can cause the disease. Bodily fluids, such as saliva, transmit mono. Therefore, it's possible to acquire the disease by sharing food or drinks, but it's more likely passed through the intimate sharing of saliva, such as kissing for a prolonged period of time.

"In fact, for this reason, mono caused by the Epstein-Barr virus is known as the kissing disease," Dr. Bigler notes. In the U.S., mono is most common in teenagers and young adults.

Classic symptoms are:

  • Fatigue
  • Fever
  • Sore throat
  • Swollen, tender lymph nodes in the neck

However, because mono is more a syndrome than an actual disease, symptoms will depend upon the cause of infection and other factors. Others can include:

  • Rash
  • Abdominal pain from an enlarged spleen
  • A variety of neurologic abnormalities within the peripheral and central nervous systems

Since certain viral infections cause mono, time is usually the best medicine. If you have a compromised immune system, your provider may prescribe an antiviral drug to treat the illness. If you get mono, you'll probably begin to feel better in a few weeks, but some symptoms may last for a few months.

Complications from mono

While most who contract mono won't have any complications, some will. If the Epstein-Barr virus causes mono, there usually aren't any serious or long-lasting medical problems. If you have a compromised immune system and catch mono, you may have more severe symptoms than the average patient. Serious complications may include:

  • A ruptured spleen
  • Encephalitis
  • Guillain-Barre syndrome
  • Cranial (head) nerve palsies
  • Fatigue that persists for several months

Although it is uncommon, certain lymphomas have an established link to the Epstein-Barr virus. A correlation with chronic fatigue syndrome has been suggested, but the association is not well established. Other long-term conditions could occur, depending on areas affected by the initial infection.
"Since your spleen may become enlarged when you have mono, you should avoid sports and other physical activities that might put you at risk of a blow to the body," says Dr. Bigler. “This will help safeguard you against a ruptured spleen.”

The immune system typically clears mono without any persistent symptoms. If you have disease, you'll always have antibodies to whichever virus caused it in the first place. This means you can't get the same kind of mono more than once. You can, however, get mono again from a different virus that can cause the syndrome.

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