Mononucleosis: Treatment and Recovery

QUESTION: My son has mononucleosis and his doctor has simply recommended he
stay home from school and rest for several weeks. The doctor hasn't
prescribed any medication other than for aches and pains. This worries me to
no end since I once knew someone who died from mono. What do you think?
Should I worry? Please tell me more about mono.
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ANSWER: Death is an extremely rare occurrence in mononucleosis patients.
Complications due to mono that are cause for concern, however, are an enlarged
spleen, which could rupture, or asphyxiation due to an airway passage
obstruction. This usually results from the massive enlargement of the tonsils
and adenoids. As I've already said, these complications are very rare.
Infectious mononucleosis is caused by an Epstein-Barr virus infection. The
disease is usually transmitted in adolescents and young adults by the intimate
exchange of saliva, which is why mono is often referred to as the "kissing
disease." The first symptoms of mono include headache, sore throat, weakness,
and mental and physical fatigue. Swollen eyelids are common.
The symptoms may occur anywhere from one to three weeks after infection.
Many mono sufferers initially think they have the flu, since the symptoms are
very similar. Within a few days, however, victims begin suffering from
painful swollen glands. The swelling may occur in the neck, armpits, and/or
the groin. Although many of the physical symptoms may disappear, the
weakness, fatigue, and overall lack of energy persist. What's actually
occurring within the body is this: the Epstein-Barr virus has invaded the
body's cells which are responsible for antibody formation and many of those
cells are immortalized. Fortunately, other cells generally launch an
immunologic counterattack.
The primary battlefields for these attacks and counterattacks are the
lymph organs, which include the tonsils, lymph nodes and spleen.
Ten percent of patients develop jaundice. Five to fifteen percent may
develop skin rashes. In rare cases, the heart, lungs, lower gastrointestinal
tract or joints may become involved. One percent of patients may experience
neurological complications. Most cases are not very dangerous, though, and no
specific therapy exists.
Rest is essential to recovery. Recent studies on Harvard students show
that strict bed rest is not mandated in most cases. In fact, light to
moderate activity seemed to quicken recovery rather than impede it.
In general, it takes at least a month until mono sufferers can return to
their normal daily activity. As far as medication goes, antibiotics don't
help, because mono is a viral disease.
Aspirin or an aspirin substitute is advised to relieve discomfort.
Lozenges and salt water gargles can ease throat pain.
During regular checkups, your doctor will carefully examine your son to
monitor the size of the spleen. Blood tests will be taken that check on the
function of the liver, and reveal how rapidly the patient is recovering. It's
also a good time to get a general evaluation of the amount of activity that
can safely be performed, and perhaps when school can start up again.
I don't think you should be overly worried about your son. Just see that
he takes the problem seriously and gets plenty of rest and checkups, and he
should recover properly.