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InfectiousICD-10: B27About 90% of adults worldwide have EBV antibodies; symptomatic mono peaks in ages 15–25

Mononucleosis

Also known as: Mono, The Kissing Disease, Glandular Fever

Infectious mononucleosis is a common viral illness most often caused by the Epstein-Barr virus (EBV), spread through saliva, shared drinks, and close contact. It is most common in teenagers and young adults and is characterized by extreme fatigue, sore throat, swollen lymph nodes, and fever. Most people recover within 2–4 weeks, although fatigue can persist for months.

Symptoms

Extreme fatigue and malaise
Severe sore throat, often mistaken for strep
Swollen lymph nodes in the neck and armpits
Fever
Swollen tonsils with white patches
Headache
Skin rash (especially after taking amoxicillin)
Enlarged spleen (splenomegaly)
Enlarged liver (hepatomegaly)

Causes

  • Epstein-Barr virus (EBV) — the most common cause
  • Cytomegalovirus (CMV) in some cases
  • Transmission through saliva, kissing, or shared utensils

Risk Factors

  • Age 15–25 (most common age group)
  • College students and military recruits in close quarters
  • Intimate contact with an infected person
  • Weakened immune system

Diagnosis

  • Monospot test (heterophile antibody test)
  • EBV-specific antibody panel (VCA IgM, VCA IgG, EBNA)
  • Complete blood count showing atypical lymphocytes
  • Liver function tests if hepatitis is suspected

Treatment

  • Rest and adequate hydration
  • Over-the-counter pain relievers (acetaminophen, ibuprofen) — avoid aspirin in young people
  • Throat lozenges and saltwater gargles for sore throat
  • Avoiding contact sports for at least 3–4 weeks to prevent splenic rupture
  • Corticosteroids only for severe complications (airway obstruction, severe hepatitis)

Prevention

  • Avoid kissing or sharing drinks with infected individuals
  • Practice good hand hygiene
  • Do not share personal items like toothbrushes or utensils

When to See a Doctor

  • Severe sore throat lasting more than a few days
  • Sharp, sudden pain in the upper left abdomen (possible splenic rupture)
  • Difficulty breathing or swallowing
  • Persistent fever or jaundice

Frequently Asked Questions

Related Conditions

Pharyngitis

Infectious

Strep Throat

Infectious

Hepatitis A

Infectious

Chronic Fatigue Syndrome

Neurological

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