Mononucleosis, often called the kissing disease, is an infection caused by the Epstein-Barr virus. It spreads through saliva and can lead to symptoms such as high fever, sore throat, white patches in the throat, and swollen lymph nodes in the neck.
The Epstein-Barr virus can infect people of any age, but symptoms usually appear in teens and adults. Children are often asymptomatic and generally do not require treatment.
Although there is no specific treatment for mononucleosis, the infection usually clears up within 1 to 2 weeks. Recovery typically involves rest, staying hydrated, and using medications to ease symptoms.
Main symptoms
The main symptoms of mononucleosis include:
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High fever
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Sore throat
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White patches on the mouth, tongue, and/or throat
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Swollen lymph nodes in the neck
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Persistent headache
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Extreme fatigue
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General malaise
Symptoms usually appear 3 to 6 weeks after exposure to the Epstein-Barr virus, although this period may be shorter depending on the person’s immune system.
Because the symptoms of mononucleosis can resemble those of the flu or a common cold, medical evaluation is important if they last longer than 2 weeks. A primary care doctor or infectious disease specialist can confirm the diagnosis.
Symptoms test
To check the likelihood of having mononucleosis, select the symptoms you are experiencing in the following test:
This test is for guidance only. It does not provide a diagnosis and is not a substitute for medical consultation with a doctor.
How to confirm a diagnosis
A doctor, usually a primary care physician or an infectious disease specialist, diagnoses mononucleosis by reviewing symptoms and performing a physical exam.
Laboratory tests are only recommended when symptoms are unclear or when it is necessary to rule out other viral infections.
Possible tests include a complete blood count or blood tests to check for antibodies against the Epstein-Barr virus.
How transmission happens
Mononucleosis is a highly contagious infection that spreads easily from person to person.
The main forms of transmission include:
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Saliva, most commonly through kissing, which is why it is called the kissing disease
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Inhalation of saliva droplets released by coughing or sneezing
Sharing cups or utensils with an infected person can also spread the virus.
Is mononucleosis serious?
Mononucleosis is generally not serious in people with a healthy immune system.
However, in individuals with weakened immunity, the infection can be more severe and harder to control. In these cases, there is a higher risk of complications such as inflammation of the brain or spinal cord, or Guillain-Barré syndrome.
Treatment options
There is no specific treatment for mononucleosis, as the body’s immune system is usually able to fight off the Epstein-Barr virus.
A doctor may recommend:
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Rest for 1 to 2 weeks, or as advised
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Drinking plenty of fluids, such as water, teas, or natural juices, to support recovery
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Avoiding contact sports and heavy lifting for at least 3 weeks after symptoms begin, to lower the risk of spleen rupture
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Taking pain relievers and fever reducers, such as acetaminophen (Tylenol), to reduce fever and relieve headaches
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Using anti-inflammatory medications, such as ibuprofen or diclofenac, to ease sore throat pain and reduce swollen lymph nodes
If a secondary infection develops, such as tonsillitis, a doctor may prescribe antibiotics like amoxicillin or penicillin.
Possible complications
Complications of mononucleosis are more likely in people who do not follow medical advice or have weakened immune systems, allowing the virus to progress.
These complications may include liver inflammation or an enlarged spleen, which can sometimes rupture. Read more about a ruptured spleen and how this can present.
In such cases, severe abdominal pain and swelling may occur, and it is important to seek medical care promptly.
Rare complications may also develop, such as anemia, inflammation of the heart, or central nervous system infections like meningitis.