Treatment:

The goal of treatment is to relieve symptoms. Medicines such as steroids (prednisone) and antivirals (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.

You should also avoid contact sports while the spleen is swollen (to prevent it from rupturing).

Expectations (prognosis):

The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Fatigue usually goes away within a few weeks, but may linger for 2 to 3 months.

Complications:

• Death in persons with weakened immune systems
• Hemolytic anemia
• Hepatitis with jaundice (more common in patients older than 35)
• Inflammation of the testicles (orchitis)
• Neurological complications (rare), including:
  • Guillain-Barre syndrome
  • Meningitis
  • Seizures
  • Temporary facial paralysis (Bell's palsy)
  • Uncoordinated movements (ataxia)
• Secondary bacterial throat infection
• Spleen rupture (rare; avoid pressure on the spleen)

Calling your health care provider:

The initial symptoms of mono feel very much like a typical viral illness. It is not necessary to contact a health care provider unless symptoms last longer than 10 days or you develop the following:

• Abdominal pain
• Breathing difficulty
• Persistent high fevers (more than 101.5°F)
• Severe headache
• Severe sore throat or swollen tonsils
• Weakness in the arm or legs
• Yellow discoloration of your eyes or skin

Call 911 or go to an emergency room if you develop:

• Sharp, sudden, severe abdominal pain
• Significant difficulty swallowing or breathing
• Stiff neck or severe weakness