BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuMononucleosisMono; Kissing disease; Glandular feverMononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck. Causes Mono is often spread by saliva and close contact. It is known as "the kissing disease." Mono occurs most often in people ages 15 to 17, but the infection may develop at any age.Mono is caused by the Epstein-Barr virus (EBV). Rarely, it is caused by other viruses, such as cytomegalovirus (CMV). Symptoms Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. Often, the lymph nodes in the neck are swollen and painful.A pink, measles-like rash can occur, and is more likely if you take the medicine ampicillin or amoxicillin for a throat infection. (Antibiotics are typically not given without a test that shows you have a strep infection.)Common symptoms of mono include:Drowsiness DrowsinessDrowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...Read Article Now Book Mark Article Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article General discomfort, uneasiness, or ill feeling Loss of appetite Loss of appetiteA decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.Read Article Now Book Mark Article Muscle aches or stiffness Muscle achesMuscle aches and pains are common and can involve more than one muscle. Muscle pain also can involve ligaments, tendons, and fascia. Fascias are th...ImageRead Article Now Book Mark Article Rash RashRashes involve changes in the color, feeling or texture of your skin.ImageRead Article Now Book Mark Article Sore throat Swollen lymph nodes, most often in the neck and armpit Swollen lymph nodesLymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...ImageRead Article Now Book Mark Article Less common symptoms are:Chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Cough CoughCoughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...ImageRead Article Now Book Mark Article Fatigue FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Headache HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...ImageRead Article Now Book Mark Article Hives HivesHives are raised, often itchy, red bumps (welts) on the surface of the skin. They can be an allergic reaction to food or medicine. They can also ap...ImageRead Article Now Book Mark Article Jaundice (yellow color to the skin and whites of the eyes) Neck stiffness Neck stiffnessJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Nosebleed NosebleedA nosebleed is loss of blood from the tissue lining the nose. Bleeding most often occurs from one nostril only.ImageRead Article Now Book Mark Article Rapid heart rate Rapid heart rateA bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.ImageRead Article Now Book Mark Article Sensitivity to light Sensitivity to lightPhotophobia is eye discomfort in bright light.ImageRead Article Now Book Mark Article Shortness of breathShortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Exams and Tests Your health care provider will examine you. They may find: Swollen lymph nodes in the front and back of your neck Swollen tonsils with a whitish-yellow covering Swollen liver or spleen Skin rash Blood tests will be done, including: White blood cell (WBC) count -- will be higher than normal if you have mono Monospot test -- will be positive for infectious mononucleosis Monospot testThe mononucleosis spot test looks for 2 antibodies in the blood. These antibodies appear during or after an infection with the virus that causes mon...ImageRead Article Now Book Mark Article Antibody titer -- tells the difference between a current and past infection Antibody titerAntibody titer is a laboratory test that measures the level of antibodies in a blood sample.ImageRead Article Now Book Mark Article Treatment The goal of treatment is to relieve symptoms. Steroid medicine (prednisone) 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. Also avoid contact sports if your spleen is swollen (to prevent it from rupturing). Outlook (Prognosis) The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Tiredness usually goes away within a few weeks, but it may linger for 2 to 3 months. Nearly everyone recovers completely. Possible Complications Complications of mononucleosis may include:Anemia, which occurs when red blood cells in the blood die sooner than normal Hepatitis with jaundice (more common in people older than 35) HepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Swollen or inflamed testicles Nervous system problems (rare), such as Guillain-Barré syndrome, meningitis, seizures, damage to the nerve that controls movement of the muscles in the face (Bell palsy), and uncoordinated movements Guillain-Barré syndromeGuillain-Barré syndrome (GBS) is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the peripher...ImageRead Article Now Book Mark Article SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Bell palsyBell palsy is a disorder of the nerve that controls movement of the muscles in the face. This nerve is called the facial or seventh cranial nerve. D...ImageRead Article Now Book Mark Article Spleen rupture (rare, avoid pressure on the spleen) Skin rash (uncommon) Skin rashGianotti-Crosti syndrome is a childhood skin condition that may be accompanied by mild symptoms of fever and malaise. It may also be associated with...ImageRead Article Now Book Mark Article Death is possible in people who have a weakened immune system. When to Contact a Medical Professional The early symptoms of mono feel very much like any other illness caused by a virus. You do not need to contact a provider unless your symptoms last longer than 10 days or you develop:Abdominal pain Breathing difficulty Persistent high fevers (more than 101.5°F or 38.6°C) Severe headache Severe sore throat or swollen tonsils Weakness in your arms or legs Yellow color in your eyes or skin Call 911 or the local emergency number or go to an emergency room if you develop: Sharp, sudden, severe abdominal pain Stiff neck or severe weakness Trouble swallowing or breathing Prevention People with mono may be contagious while they have symptoms and for up to a few months afterwards. How long someone with the disease is contagious varies. The virus can live for several hours outside the body. Avoid kissing or sharing utensils if you or someone close to you has mono.Open ReferencesReferencesEbell MH, Call M, Shinholser J, Gardner J. Does this patient have infectious mononucleosis?: the rational clinical examination systematic review. JAMA. 2016;315(14):1502-1509. PMID: 27115266 pubmed.ncbi.nlm.nih.gov/27115266/. Johannsen EC, Kaye KM. Epstein-Barr virus (infectious mononucleosis, Epstein-Barr virus-associated malignant diseases, and other diseases). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 138.Weinberg JB. Epstein-Barr virus. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 281.Winter JN. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 159.AllVideoImagesTogMononucleosis - photomicrograph of cells - illustration This so-called Downy cell is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.Mononucleosis - photomicrograph of cellsillustrationMononucleosis - photomicrograph of cells - illustration This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a Downy cell. Downy cells may be classified as types I, II, or III. this is a type I Downy cell.Mononucleosis - photomicrograph of cellsillustrationInfectious mononucleosis #3 - illustration Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.Infectious mononucleosis #3illustrationAcrodermatitis - illustration Acrodermatitis enteropathica is a skin condition peculiar to children that may be accompanied by mild symptoms of fever and malaise. It may also be associated with hepatitis B infection or other viral infections. The lesions appear as small coppery-red, flat-topped firm papules that appear in crops and sometime in long linear strings, often symmetric.AcrodermatitisillustrationSplenomegaly - illustration Splenomegaly is an enlargement of the spleen.SplenomegalyillustrationInfectious mononucleosis - illustration Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.Infectious mononucleosisillustrationMononucleosis - photomicrograph of cell - illustration This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.Mononucleosis - photomicrograph of cellillustrationGianotti-Crosti syndrome on the leg - illustration Gianotti-Crosti disease is also called acrodermatitis of childhood. These red, elevated lesions do not contain pus and can occur on the limbs, buttocks, face, and neck.Gianotti-Crosti syndrome on the legillustrationMononucleosis - view of the throat - illustration Infectious mononucleosis causes a sore throat, enlarged lymph nodes, and fatigue. The throat may appear red and the tonsils covered with a whitish material. Mononucleosis and severe streptococcal tonsillitis appear quite similar. Unless there are other findings to suggest mononucleosis, a throat culture and blood studies may be necessary to make an accurate diagnosis.Mononucleosis - view of the throatillustrationMononucleosis - mouth - illustration Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.Mononucleosis - mouthillustrationAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationMononucleosis - photomicrograph of cells - illustration This so-called Downy cell is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.Mononucleosis - photomicrograph of cellsillustrationMononucleosis - photomicrograph of cells - illustration This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a Downy cell. Downy cells may be classified as types I, II, or III. this is a type I Downy cell.Mononucleosis - photomicrograph of cellsillustrationInfectious mononucleosis #3 - illustration Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.Infectious mononucleosis #3illustrationAcrodermatitis - illustration Acrodermatitis enteropathica is a skin condition peculiar to children that may be accompanied by mild symptoms of fever and malaise. It may also be associated with hepatitis B infection or other viral infections. The lesions appear as small coppery-red, flat-topped firm papules that appear in crops and sometime in long linear strings, often symmetric.AcrodermatitisillustrationSplenomegaly - illustration Splenomegaly is an enlargement of the spleen.SplenomegalyillustrationInfectious mononucleosis - illustration Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.Infectious mononucleosisillustrationMononucleosis - photomicrograph of cell - illustration This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.Mononucleosis - photomicrograph of cellillustrationGianotti-Crosti syndrome on the leg - illustration Gianotti-Crosti disease is also called acrodermatitis of childhood. These red, elevated lesions do not contain pus and can occur on the limbs, buttocks, face, and neck.Gianotti-Crosti syndrome on the legillustrationMononucleosis - view of the throat - illustration Infectious mononucleosis causes a sore throat, enlarged lymph nodes, and fatigue. The throat may appear red and the tonsils covered with a whitish material. Mononucleosis and severe streptococcal tonsillitis appear quite similar. Unless there are other findings to suggest mononucleosis, a throat culture and blood studies may be necessary to make an accurate diagnosis.Mononucleosis - view of the throatillustrationMononucleosis - mouth - illustration Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.Mononucleosis - mouthillustrationAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. Antibodiesillustration Tests for Mononucleosis Mononucleosis spot testRelated Information Non-Hodgkin lymphoma(Condition)Seizures(Symptoms)Movement - uncoordinated(Symptoms)Guillain-Barre syndrome(Condition)Bell palsy(Condition)Hepatitis(Condition)Hemolytic anemia(Condition)Orchitis(Condition)Non-Hodgkin's lymphoma - InDepth(In-Depth)Hepatitis - InDepth(In-Depth) Review Date: 3/10/2022 Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. 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MononucleosisMono; Kissing disease; Glandular feverMononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck. Causes Mono is often spread by saliva and close contact. It is known as "the kissing disease." Mono occurs most often in people ages 15 to 17, but the infection may develop at any age.Mono is caused by the Epstein-Barr virus (EBV). Rarely, it is caused by other viruses, such as cytomegalovirus (CMV). Symptoms Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. Often, the lymph nodes in the neck are swollen and painful.A pink, measles-like rash can occur, and is more likely if you take the medicine ampicillin or amoxicillin for a throat infection. (Antibiotics are typically not given without a test that shows you have a strep infection.)Common symptoms of mono include:Drowsiness DrowsinessDrowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...Read Article Now Book Mark Article Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article General discomfort, uneasiness, or ill feeling Loss of appetite Loss of appetiteA decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.Read Article Now Book Mark Article Muscle aches or stiffness Muscle achesMuscle aches and pains are common and can involve more than one muscle. Muscle pain also can involve ligaments, tendons, and fascia. Fascias are th...ImageRead Article Now Book Mark Article Rash RashRashes involve changes in the color, feeling or texture of your skin.ImageRead Article Now Book Mark Article Sore throat Swollen lymph nodes, most often in the neck and armpit Swollen lymph nodesLymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...ImageRead Article Now Book Mark Article Less common symptoms are:Chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Cough CoughCoughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...ImageRead Article Now Book Mark Article Fatigue FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Headache HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...ImageRead Article Now Book Mark Article Hives HivesHives are raised, often itchy, red bumps (welts) on the surface of the skin. They can be an allergic reaction to food or medicine. They can also ap...ImageRead Article Now Book Mark Article Jaundice (yellow color to the skin and whites of the eyes) Neck stiffness Neck stiffnessJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Nosebleed NosebleedA nosebleed is loss of blood from the tissue lining the nose. Bleeding most often occurs from one nostril only.ImageRead Article Now Book Mark Article Rapid heart rate Rapid heart rateA bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.ImageRead Article Now Book Mark Article Sensitivity to light Sensitivity to lightPhotophobia is eye discomfort in bright light.ImageRead Article Now Book Mark Article Shortness of breathShortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Exams and Tests Your health care provider will examine you. They may find: Swollen lymph nodes in the front and back of your neck Swollen tonsils with a whitish-yellow covering Swollen liver or spleen Skin rash Blood tests will be done, including: White blood cell (WBC) count -- will be higher than normal if you have mono Monospot test -- will be positive for infectious mononucleosis Monospot testThe mononucleosis spot test looks for 2 antibodies in the blood. These antibodies appear during or after an infection with the virus that causes mon...ImageRead Article Now Book Mark Article Antibody titer -- tells the difference between a current and past infection Antibody titerAntibody titer is a laboratory test that measures the level of antibodies in a blood sample.ImageRead Article Now Book Mark Article Treatment The goal of treatment is to relieve symptoms. Steroid medicine (prednisone) 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. Also avoid contact sports if your spleen is swollen (to prevent it from rupturing). Outlook (Prognosis) The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Tiredness usually goes away within a few weeks, but it may linger for 2 to 3 months. Nearly everyone recovers completely. Possible Complications Complications of mononucleosis may include:Anemia, which occurs when red blood cells in the blood die sooner than normal Hepatitis with jaundice (more common in people older than 35) HepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Swollen or inflamed testicles Nervous system problems (rare), such as Guillain-Barré syndrome, meningitis, seizures, damage to the nerve that controls movement of the muscles in the face (Bell palsy), and uncoordinated movements Guillain-Barré syndromeGuillain-Barré syndrome (GBS) is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the peripher...ImageRead Article Now Book Mark Article SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Bell palsyBell palsy is a disorder of the nerve that controls movement of the muscles in the face. This nerve is called the facial or seventh cranial nerve. D...ImageRead Article Now Book Mark Article Spleen rupture (rare, avoid pressure on the spleen) Skin rash (uncommon) Skin rashGianotti-Crosti syndrome is a childhood skin condition that may be accompanied by mild symptoms of fever and malaise. It may also be associated with...ImageRead Article Now Book Mark Article Death is possible in people who have a weakened immune system. When to Contact a Medical Professional The early symptoms of mono feel very much like any other illness caused by a virus. You do not need to contact a provider unless your symptoms last longer than 10 days or you develop:Abdominal pain Breathing difficulty Persistent high fevers (more than 101.5°F or 38.6°C) Severe headache Severe sore throat or swollen tonsils Weakness in your arms or legs Yellow color in your eyes or skin Call 911 or the local emergency number or go to an emergency room if you develop: Sharp, sudden, severe abdominal pain Stiff neck or severe weakness Trouble swallowing or breathing Prevention People with mono may be contagious while they have symptoms and for up to a few months afterwards. How long someone with the disease is contagious varies. The virus can live for several hours outside the body. Avoid kissing or sharing utensils if you or someone close to you has mono.Open ReferencesReferencesEbell MH, Call M, Shinholser J, Gardner J. Does this patient have infectious mononucleosis?: the rational clinical examination systematic review. JAMA. 2016;315(14):1502-1509. PMID: 27115266 pubmed.ncbi.nlm.nih.gov/27115266/. Johannsen EC, Kaye KM. Epstein-Barr virus (infectious mononucleosis, Epstein-Barr virus-associated malignant diseases, and other diseases). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 138.Weinberg JB. Epstein-Barr virus. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 281.Winter JN. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 159.