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Symptoms of Mono

Infectious mononucleosis is a common infection caused by the Epstein-Barr virus (EBV). It is also known as glandular fever, the kissing disease, and mono. Symptoms of infectious mononucleosis include fatigue, sore throat, fever, and swollen lymph nodes. There is no treatment for mono, but the care involves resting and drinking plenty of fluids. The illness resolves without treatment, but symptoms may last from several weeks to months.

What Causes Mononucleosis?

The Epstein-Barr virus causes mononucleosis in the majority of cases. This highly contagious organism is a member of the Herpesviridae family of viruses. Cytomegalovirus (CMV) can sometimes also cause an illness with the symptoms of mononucleosis.

  • Mononucleosis most often occurs in people between 5-25 years of age, with the highest occurrence rate between 15-25 years of age.
  • In developed countries, it most often occurs in those of higher socioeconomic status.
  • By adulthood, most people have already been infected with EBV.
  • Not all individuals exposed to EBV, however, develop the symptoms of mononucleosis.
  • Once infected, a person develops lifelong immunity to future infections from the disease.

How does mono rash develop?

Around 15% of the total cases of mononucleosis develop skin symptoms. Usually these are light, widespread rash which lasts for over a week or so. Known as maculopapular exanthem, these rashes are basically flat patches having small red spots. Rash develop first on the trunk and upper arms which soon spread on the face and forearms. Rash may also look like:

  • Popular – small bumps
  • Purpuric – bruise-like appearance
  • Morbilliform – small, measles-like patches
  • Vesicular- little blisters
  • Scarlatiniform – tiny spots

People with mono usually develop more intense rash than various forms mentioned above. Maculopapular or morbilliform rash develop on extensor surfaces when mononucleosis patient is treated with antibiotics like ampicillin, amoxicillin and cephalosporin. If such rashes appear then it is an indication of hypersensitivity reaction to antibiotic. But this is not a real allergy and does not mean that the person is allergic to such medications.

Sometimes the person suffering from the sore throat mononucleosis also gets streptococcal infection. It is also possible that person develops tonsil infections and sinus infection. This viral infection is also associated with tiredness right from the beginning till the symptoms disappear.

Mononucleosis can also affect other organs of the body. This includes enlarged spleen i.e. Splenomegaly, arthritis in joints, Hepatitis, glomerulonephritis, interstitial pneumonia and pericarditis. Sometimes nervous system is also affected by mono infection and causes bell’s palsy, transverse myelitis, meningoencephalitis and Guillain-Barre syndrome.


The most common symptoms of mononucleosis are fever, sore throat, swollen glands and fatigue. Symptoms usually develop between four to six weeks after exposure to the EBV. Other signs and symptoms of mononucleosis may include the following:

  • headache,
  • rash,
  • malaise,
  • tonsillitis,
  • body aches,
  • enlarged spleen and/or liver,
  • difficulty breathing.


The goal of treatment is to relieve symptoms. Steroid medicine may be given if your symptoms are severe. Antiviral drugs, such as acyclovir, have little or no benefit.

To relieve typical symptoms:

  • Drink plenty of fluids.
  • Gargle with warm salt water to ease a sore throat.
  • Get plenty of rest.
  • Take acetaminophen or ibuprofen for pain and fever.

Make sure to call a health-care provider for an appointment if any of the signs or symptoms of mononucleosis appear. Diagnosis of the illness by a health-care provider is important to make sure that it is not another medical condition that may require more extensive medical evaluation and treatment.