Exams and Tests

A medical history and physical exam are the most important ways a doctor can diagnose mono. During the medical history and physical exam, your doctor will ask questions about your symptoms and possible exposure to the disease. Your doctor will also examine you for signs of the infection. This may include looking at your throat, checking your skin, and pressing on your abdomen.

Blood tests to help confirm the diagnosis include:

• Mononucleosis tests (including the monospot test and EBV antibody test). It is possible for the monospot test to come back negative early in the course of the infection (false negative).
• Complete blood count (CBC). A CBC may be done to rule out other infections or complications of mono.

Other tests may be done if complications of mono occur or if the mononucleosis tests are negative.

• Liver tests may be done to find out whether the virus has affected your liver.
• If the mononucleosis test is negative, your doctor may test you for an infection with cytomegalovirus (CMV) or other organisms. CMV can cause an illness that is like mono.

Treatment Overview

Usually no treatment for mono is needed other than:

• Getting plenty of rest.
• Gargling with salt water or using throat lozenges to soothe your sore throat.
• Taking acetaminophen (such as Tylenol) or ibuprofen (such as Advil) to reduce fever and relieve a sore throat and headaches. Do not give aspirin to anyone under the age of 20, because its use has been linked with Reye syndrome.
• Avoiding contact sports and heavy lifting to reduce the risk of injuring your spleen.

Without other treatment, most people recover from mono after several weeks. But for some, it may take several months before they regain their normal energy levels. This extended period of fatigue is not the same as having chronic fatigue syndrome.

In severe cases, corticosteroids may be used to reduce swelling of the throat, tonsils, or spleen. This type of steroid use may also decrease the overall length and severity of illness from infectious mono.