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Mononucleosis (cont.)

IN THIS ARTICLE

What Is the Medical Treatment for Mononucleosis?

Medical treatment for mononucleosis is generally reserved for those cases in which complications arise.

  • Corticosteroids may be prescribed in rare cases of airway obstruction, hemolytic anemia (an autoimmune process in which red blood cells are destroyed), severe thrombocytopenia (a decrease in platelets, which are clotting components in the blood), and complications involving the heart and nerves.
  • Antibiotics are not used to treat mononucleosis.
  • Admission to a hospital is rarely needed, unless unforeseen complications occur.

What Is the Follow-up for Mononucleosis?

Schedule routine visits with your health-care provider after the initial diagnosis of mononucleosis has been made so that they can monitor the course of the illness and detect any possible complications. Wait for your health-care provider to give medical clearance to resume any strenuous activities or contact sports.

How Do You Prevent Mononucleosis?

Though good personal hygiene makes sense, especially among teenagers, the Epstein-Barr virus is very common in children, adolescents, and  young adults, and exposure to it cannot be entirely avoided.

  • People with mononucleosis do not need to be isolated from others.
  • Vaccines against EBV do not currently exist.

What Is the Prognosis for Mononucleosis?

Mononucleosis is generally a self-limited disease that runs its course, and the infection typically goes away in two to four weeks. Most people recover normally without any permanent health consequences.

Complications are uncommon but may be life-threatening. Death from mononucleosis is very rare and most often occurs if the spleen ruptures.

  • The spleen (which is an organ that is actually like a big lymph node) ruptures in a very low percentage of people with mononucleosis. Most of these cases occur in males. Rupture usually occurs during the second or third week of the illness when individuals start to feel better and they resume strenuous activities. If the spleen ruptures, doctors may need to surgically remove it.
  • Airway obstruction occurs in one out of every 100-1,000 cases of mononucleosis. It may occur at any age, but it is more common in young children. Corticosteroids may be used to treat this complication.
  • Autoimmune hemolytic anemia (a condition in which the body destroys its own red blood cells) occurs in a very low percentage of people with mononucleosis. It usually becomes clinically apparent during the second or third week of illness. Corticosteroids may be used to treat this complication.
  • Thrombocytopenia, which is a decrease in platelets in the blood, has been noted in up to 50% of people with mononucleosis. It is usually mild and not life-threatening. If severe, corticosteroids may be used to treat this complication.
  • Hepatitis caused by the Epstein-Barr virus occurs in a large percentage of people with mononucleosis. This condition is usually mild and goes away by itself.
  • Neurologic complications may occur, although rarely. These might include seizures, Guillain-Barré syndrome, Bell's palsy, transverse myelitis, encephalitis, meningitis, and cranial nerve palsies. Corticosteroids may be used to treat these complications.
  • Complications involving the heart, lungs, or kidneys rarely occur.
  • Infection with EBV and mono may occasionally lead to a variety of malignant conditions (cancers).

Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease

REFERENCES:

Omori, Michael S. "Mononucleosis." McNamara, Robert M. Apr. 2, 2009. eMedicine.com. Sept. 28, 2009. <http://emedicine.medscape.com/article/784513-overview>.

United States. Centers for Disease Control and Prevention. "Epstein-Barr Virus and Infectious Mononucleosis." <http://www.cdc.gov/ncidod/diseases/ebv.htm>.


Medically Reviewed by a Doctor on 11/17/2016

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