Diagnosing Mononucleosis

Mono Causes

Mononucleosis is caused by the Epstein-Barr virus (EBV), which comes from the same family as herpes. There is no way to definitively diagnose mononucleosis without a blood test, although certain symptoms may indicate the presence of the virus. Unfortunately, even once a blood test confirms a diagnosis of EBV, there are no medicinal cures for mono (nor is there a vaccine to prevent contracting mono in the first place). The primary treatment plan for mono is bed rest, drinking fluids, and minimizing discomfort while the infection runs its course.

Can A Mono Diagnosis Recur?

Although mono is often accompanied by a variety of symptoms, one can also have mono and be symptom free (as is typically the case in children), and even someone who has had mono in the past can still transmit the virus if the EBV which lies dormant in their body becomes reactivated. The good news, however, is that once one has had mono, recurrence of a mono diagnosis rarely occurs.

Mono Symptoms

The following are some of the symptoms that may lead to a mononucleosis diagnosis:

- Weakness

- Fatigue/ Excessive sleep

- Fever

- Muscle aches

- Swollen lymph nodes (in the neck and armpits)

- Headaches

- Loss of appetite

- Enlarged spleen

- Liver inflammation

- Abdominal pain

- Sore throat

- Swollen tonsils

- Skin rash

- Night sweats

Mononucleosis Blood Tests

Mononucleosis is diagnosed by blood tests wherein doctors check the blood for the presence of EBV antibodies. A white blood cell count is also performed since in the early stages of mono there may be an increase in lymphocytes (a type of white blood cell). To confirm a mono diagnosis, more specific blood tests are performed, namely monospot and heterophile antibody tests. Note that some antibodies may not appear until well into the second or third week of the condition.

Ruling Out a Mono Diagnosis

Since many of the symptoms of mononucleosis are similar to those of the common cold or influenza, additional tests may be performed to exclude other causes of symptoms. For a sore throat and/or swollen tonsils, a test for Strep throat may be conducted. Similarly, a blood chemistry test may be utilized to reveal liver function abnormalities.

Age is another factor which helps to determine a diagnosis of mono. Since most adults have already formed immunity to the EBV virus by the age of 35, doctors are more apt to be skeptical of a mononucleosis diagnosis in adults and more likely to consider the possibility of mono in teenagers and young adults.

Course and Treatment of Mononucleosis

After exposure to mononucleosis, it takes four to eight weeks for the disease to incubate and for a person to experience mono-related symptoms. Since mono is a self-limiting condition that passes with time, there is no medical treatment for mono except a recommendation for bed rest and drinking plenty of fluids. Treatment is directed, however, at relieving uncomfortable symptoms (i.e. over-the-counter meds to reduce pain and fever).

Mono symptoms typically subside over the course of several weeks to two months. If symptoms persist longer than six months the condition is labeled chronic and serious complications can occur.

Viral particles can remain present in the saliva for up to 18 months following the initial infection, after which time EBV lies dormant in a person's body. Although one rarely contracts mono twice, a person who has had mono in the past can still transmit mono to others if the virus becomes reactivated.


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