Misdiagnosing Mono

Mono, short for mononucleosis, is a highly contagious generalized infection caused by the cytomegalovirus or the Epstein-Barr virus. It is transmitted from close contact between people.

Some methods of transmission include sexual contact, saliva, through a fecal-oral route, by needle, or contact with blood or through blood transfusions. Mothers can also transfer the infection to their unborn children.

Mono has many symptoms that mimic other diseases so misdiagnosis is possible, especially during the early stages of the infection.

Eight common diseases or conditions the infection can appear to initially be are chronic fatigue syndrome, lymphoma, strep throat, influenza, the common cold, upper respiratory infections, tonsillitis, or pharyngitis.

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome is a disorder where the patient suffers severe fatigue that doesn't go away no matter how much rest the person gets. It often gets worse after exercise or mental stress or activity. The disorder can also cause a significant amount of physical chronic pain.

Some symptoms of mono also include chronic fatigue and pain. Since there are no specific tests for chronic fatigue syndrome so it's difficult to figure out whether the symptoms are caused by a mostly genetic disorder or an infectious virus.


Those who have lymphoma suffer from a mutation of their white blood cells (lymphocytes) which are responsible for fighting infections. This often causes malignant tumors to grow in the lymph glands.

Although mono patients rarely have malignant tumors, they can have swollen lymph glands which sometimes lead to a misdiagnosis. Lymphoma can also be caused by the Epstein-Barr virus, the same one that often causes mononucleosis.

Strep Throat, Tonsillitis and Pharyngitis

These three illnesses involve inflammation of the throat (strep), tonsils (strep and tonsillitis) or the larynx (pharyngitis). A symptom of mono is gland swelling in throat which can sometimes lead to the misdiagnosis of any one of these infections.

Strep throat is a bacterial infection that causes swelling and inflammation of the throat. The throat and tonsils become red and swollen; patients often have difficulty swallowing and also have headaches and swollen lymph nodes, just as they would with a mono infection.

Not all those infected with strep throat will have a sore throat, which is the same with a mono infection.

Tonsillitis has similar symptoms, but most patients will have throat pain.

Pharyngitis is inflammation or infection of the larynx often accompanied by a fever and body aches.

Influenza, the Common Cold, Upper Respiratory Infections

Influenza is a viral respiratory infection that's highly contagious like mono. Symptoms are similar to mono with aching muscles, headaches, fever, chills and fatigue.

The common cold is also a very contagious viral respiratory infection with symptoms like a runny nose, fatigue and body aches. The severity of these symptoms vary but they're rarely life threatening.

Early stages of mono can mimic the symptoms of the common cold, but typically increase in severity. The same is true with general upper respiratory illnesses.

Reducing the Chance of a Misdiagnosis

If you suspect you may have mono, insist your doctor completes a series of tests including blood tests, a throat swab culture and EBV antibody tests.


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