Published: 18 Jun 2025

ICD9: 075      ICD10: B27.90      ICD11: 1D81

Mononucleosis, often called "Mono" or the "Kissing Disease," is an infectious disease caused primarily by the Epstein-Barr virus (EBV).


Here's a breakdown:

Cause: Primarily Epstein-Barr virus (EBV). Less common causes include cytomegalovirus (CMV) and, rarely, other viruses.

Transmission: EBV is most commonly spread through saliva. This is why it's sometimes called the "kissing disease." It can also be spread through sharing drinks, utensils, or other personal items.

Symptoms: Symptoms can vary from mild to severe and may include:
Extreme fatigue: This is a hallmark symptom and can last for weeks or even months.
Sore throat: Often severe and difficult to swallow.
Fever
Swollen lymph nodes: Especially in the neck and armpits.
Headache
Body aches
Swollen tonsils: Often with white patches or pus.
Enlarged spleen: (Splenomegaly). This can be dangerous as the spleen is more prone to rupture if hit.
Enlarged liver: (Hepatomegaly)
Skin rash: Sometimes occurs, especially if taking certain antibiotics like ampicillin or amoxicillin.

Diagnosis: Mono is usually diagnosed based on symptoms and a physical exam. A blood test called the "Monospot test" or "heterophile antibody test" can help confirm the diagnosis. Other blood tests may be used to check for elevated liver enzymes and white blood cell counts.

Treatment: There is no specific cure for Mono. Treatment focuses on managing symptoms and allowing the body to fight off the infection. Recommendations include:
Rest: This is crucial, especially in the early stages.
Plenty of fluids: To stay hydrated.
Pain relievers: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help with fever, sore throat, and body aches. Aspirin should be avoided in children and teenagers due to the risk of Reye's syndrome.
Gargling with salt water: May help soothe a sore throat.
Avoid contact sports: Due to the risk of spleen rupture, avoid contact sports and strenuous activities for several weeks or months after symptoms subside, as recommended by a doctor.
Corticosteroids: In rare cases, corticosteroids may be prescribed to reduce inflammation, particularly if there are complications.

Complications: Although rare, complications can occur, including:
Spleen rupture: A serious complication requiring immediate medical attention.
Liver problems: Hepatitis (inflammation of the liver) is common, but usually mild.
Neurological complications: Rare, but can include encephalitis (inflammation of the brain), meningitis (inflammation of the membranes surrounding the brain and spinal cord), and Guillain-Barré syndrome.
Secondary infections: Such as strep throat or sinus infections.
Anemia: Low red blood cell count.
Thrombocytopenia: Low platelet count.

Prognosis: Most people recover from mono within a few weeks to a few months. Fatigue can sometimes linger for longer. Once you've had mono, you are typically immune to EBV for life, although the virus can remain dormant in your body.

Prevention: There's no vaccine for mono. The best way to prevent it is to avoid close contact with people who have the infection. Don't share drinks, utensils, or personal items. Good hygiene practices, such as frequent handwashing, can also help.

Important Note: If you suspect you have mono, it's important to see a doctor for diagnosis and treatment. They can rule out other possible causes of your symptoms and advise you on how to manage your condition. Self-treating can be dangerous, especially regarding complications like a ruptured spleen.