Mononucleosis - Diagnosis and Treatment

Mononucleosis—people often call it “the kissing disease”—is a very common viral infection. It spreads easily through saliva, so teens and young adults catch it a lot, but really, anyone can get it.

You might notice tiredness, a sore throat, and swollen glands. Usually, mono clears up on its own, but that exhaustion can drag on for weeks. Mono usually isn’t life-threatening, but people with weak immune systems may need extra attention.

Knowing what’s coming can help you deal with it and figure out how to manage your daily life.

Diagnosis

Examining Physical Signs

Doctors usually start by checking for classic signs of mono. They look for swollen lymph nodes—especially in your neck.

They also check for enlarged tonsils, a bigger spleen, or a swollen liver. Then they ask about how long you’ve felt sick and what symptoms you’ve noticed, like fever, sore throat, or fatigue.

All these details help them decide if you need more tests.

Checking the Blood

Doctors often use blood tests to help diagnose mono. One common test is the heterophile antibody test (the monospot test), which checks for antibodies your body makes against the Epstein-Barr virus.

This test can show results in about a day, but sometimes it’s not positive right away.

Doctors might also look at your blood under a microscope to see if you have more lymphocytes or weird-looking white blood cells called atypical lymphocytes.

Sometimes, they use more specific tests for antibodies to certain parts of the virus, like the viral capsid antigen. These tests help doctors rule out other illnesses, such as strep throat or cytomegalovirus.

Sometimes, doctors confuse mono with other infections like toxoplasmosis, adenovirus, or even bacterial infections, since symptoms can look similar.

Treatment

Medicines That May Help

There isn’t a medicine that cures mono. Most people just need rest, lots of fluids, and healthy food.

Here’s a quick table about some medicines:

Medicine Type	Common Use	Safe for Mono?
Acetaminophen, Ibuprofen	Ease pain/fever	Yes
Penicillin antibiotics	Treat bacterial infection	No (may cause rash)
Other antibiotics	Treat bacterial infection	Sometimes
Corticosteroids	Reduce throat swelling	In severe cases
Antivirals	Antiviral	Not effective

Over-the-counter medicines like acetaminophen or ibuprofen can lower fever and help with sore throat or aches. These don’t fight the virus, but they make you feel a bit better.

If you end up with another infection, like strep throat or a sinus infection, your doctor might give you antibiotics. Not all antibiotics are safe, though.

Penicillin-based ones can cause a rash if you have mono, so doctors usually avoid them. If you really need antibiotics, your doctor will pick something less likely to cause problems.

If your throat swells a lot and you have trouble breathing, a doctor might suggest corticosteroids to help with the swelling. An antiviral drug doesn’t actually work for mono.

Self care

Taking care of yourself really matters when you’re dealing with mono. Good self-care can help with fever, sore throat, headache, rash, tiredness, and those annoying body aches.

It also helps you recover faster and lowers your risk of complications.

Symptom	Self-Care Tip
Sore throat	Gargle salt water; drink warm fluids
Headache/Body aches	Use acetaminophen or ibuprofen
Fatigue	Take frequent rest breaks and naps
Fever	Stay hydrated; take fever reducer
Rash	Wear loose, comfortable clothing
Nausea	Eat light meals; drink fluids slowly

Stay Hydrated: Drink water, fruit juice, herbal tea, or clear broths. Fluids keep dehydration away, help cool a fever, and soothe your throat.
Relieve Pain and Fever: Over-the-counter pain relievers like acetaminophen or ibuprofen can help with fever, headaches, body aches, and even stomach pain. Don’t give aspirin to kids or teens—it can cause serious problems.
Rest Often: Nap and sleep more if you need to. Rest helps your body fight the infection and deal with fatigue or loss of appetite.
Gargle with Salt Water: Mix 1/4 teaspoon of salt in warm water and gargle a few times a day. It can soothe your sore throat.
Eat Small, Healthy Meals: If you’re not hungry or you feel nauseous, stick to gentle foods like soup, fruit, and simple grains. They’ll give you energy while you recover.

Postpone sports and high-risk activities

Hold off on regular exercise, contact sports, or heavy lifting until your doctor says it’s okay. Your spleen might still be enlarged after mono, and a hit to the belly could be risky.

Most people start feeling better after a few weeks, but tiredness can linger for two or three months. During recovery, avoid rough play, intense sports, or heavy work for at least four weeks—or until your doctor gives you the green light.

Check with your healthcare provider before jumping back into activities. Sometimes, they’ll suggest gentle movement or stretching before you go back to your usual routine. Taking it slow can help you avoid setbacks and fully recover.

Ways to Manage and Find Support

Getting over mono isn’t always easy, especially if you miss school, sports, or group stuff. Rest at home until you’re ready to get back to your normal routine.

If you’re a student, keep your teachers or school staff in the loop so you can get help while you’re out.

Support tips:

Ask friends or family to help with chores or schoolwork.
Reach out to a school counselor or Healthnile student health staff if you need extra support or treatment.
Drink plenty of fluids and use over-the-counter meds for your symptoms.
Don’t share drinks, food, or personal items to avoid spreading the virus.
Wash your hands often and be careful with saliva, since that’s how mono spreads.

Getting help and being careful about spreading germs can make things easier for everyone.

Getting Ready for Your Visit

Getting ready for your doctor’s visit can make things smoother and help you remember all your questions. This is especially true for teens or college students going to the doctor alone.

List Your Symptoms: Jot down every symptom you’ve noticed, even if it seems minor or unrelated.
Note Personal Details: Mention any recent stress, big life changes, changes in your routine, or if you’ve been near someone with mono.
Document Medications and Supplements: Make a list of any meds, vitamins, or supplements you take.
Prepare Questions: Having questions ready makes it easier to remember what you want to ask. Here are some ideas:

Topic	Possible Questions
Reason for symptoms	“What could be causing my symptoms?”
Alternative causes	“Are there other possible reasons?”
Testing	“What tests should I expect?”
Managing other health issues	“Can my other conditions affect treatment?”
Activity limits	“Are there things I should avoid doing?”
Absence from school or work	“How long should I stay home?”
Returning to sports/exercise	“When can I start my normal activities?”
Medication safety	“Are there medicines I should not take?”

Tip: Don’t be shy about asking anything else that comes up. Writing your questions in a notebook or on your phone can help you remember during your appointment.

Questions Your Health Provider May Ask You

Doctors will ask certain questions to get a better idea of what’s going on. Being ready for these can help your visit go faster and help you get the best care.

When did your symptoms start?
Are your symptoms constant, or do they come and go?
How bad are your symptoms right now?
Has anything made them better or worse?
Have you been around anyone with mono?
Can you go to school, college, or work, or has your routine changed?

Your answers help your doctor decide on tests, figure out if you need to stay home, and come up with the best plan for recovery.

Remember: It helps to be open about how you’re feeling. Talk about your schoolwork, sports, or changes in sleep—these are common issues for students and teens.

If you’re worried about missing school or keeping up, mention it. Your provider can offer advice that fits your situation.

Mononucleosis – Diagnosis and Treatment