How is mono diagnosed?

How is mono diagnosed?

A diagnosis of mono is suspected by the doctor based on the patient's symptoms and signs. Mono is confirmed by blood tests that may also include tests to exclude other possible causes of the symptoms, such as tests to rule out Strep throat. Early in the course of mono, blood tests may show an increase in one type of white blood cell (lymphocyte). Some of these increased lymphocytes have an unusual or "atypical" appearance when viewed under a microscope, which suggests mono.

More specific blood tests, such as the monospot and heterophile antibody tests, can confirm the diagnosis of mono. These tests rely on the body's immune system to make measurable antibodies against the EBV. Unfortunately, the antibodies may not become detectable until the second or third week of the illness. A blood chemistry test may reveal abnormalities in liver function.

What is the usual course and treatment of mono?

In most cases of mono, no specific treatment is necessary. The illness is usually self-limited and resolves in much the same way as other common viral illnesses. Treatment is directed toward the relief of symptoms. Available antiviral drugs have no significant effect on the overall outcome of mono and may actually prolong the course of the illness. For the most part, supportive or comfort measures are all that is necessary. Acetaminophen can be given for fever and any body- or headaches. A sufficient amount of sleep and rest is important. The throat soreness is worst during the first five to seven days of illness and then subsides over the next seven to 10 days.

Are there any long-term effects of mono?

A feeling of fatigue or tiredness may persist for months following the acute phase of the illness. It is recommended that patients with mono avoid participation in any contact sports during the first six to eight weeks following the onset to prevent trauma to the enlarged spleen. Patients can continue to have virus particles present in their saliva for as long as 18 months after the initial infection. When symptoms persist for more than six months, the condition is frequently called "chronic" EBV infection.

Approximately 20%-80% of people who have had mono will continue to secrete the EBV in their saliva for years due to periodic "reactivations."