3 Unexpected Symptoms of Mononucleosis

You probably already know mononucleosis (or mono) as the “kissing disease.” It gained this nickname because the virus that causes this contagious illness is spread through contact with the saliva of a person who is infected.

Mono is caused by the Epstein-Barr virus (EBV), which it turns out up to 95% of American adults have in their bodies. Most people probably became infected as children, who either don’t show symptoms or have very mild symptoms similar to a cold. The virus then goes dormant, but it can be reactivated by a weakened immune system or stress.

Typical symptoms of mono include: 

• Extreme fatigue
• Fever
• Sore throat
• Skin rash
• Body aches
• Enlarged lymph nodes
• Loss of appetite

When Adam Redlich, MD, and our team at A+ Athlete Sports Medicine treat patients with mono, we tell them symptoms usually last 2-4 weeks, but it may still be a couple of months before you feel back to full strength.

There’s no medication to treat mono since it doesn’t respond to antibiotics or antiviral treatments. We usually recommend plenty of rest and fluids, nonprescription pain relievers, sore throat treatments (cough drops, popsicles, etc.), and avoiding strenuous physical activity.

Even following these protocols, however, three unexpected symptoms of mono can rear their heads.

1. Enlarged spleen

Mono can cause your spleen to become swollen and enlarged for several weeks. Your spleen is located in the upper left side of your abdomen. If you feel a sudden, sharp pain in this area, you need to seek medical attention as soon as possible. The pain could be a sign that your spleen has ruptured. This happens very rarely, but you should be aware of the possibility.

This danger is also why we recommend that if you have mono, you avoid any sports or activities that could cause physical contact. Any hard blows could cause the spleen to rupture.

2. Dehydration

Mono can also sometimes lead to mild or severe dehydration due to loss of fluids from fever and cough. You may also not want to drink fluids because of pain in your throat and neck. Signs of dehydration include a very dry mouth, increased thirst, headaches, decreased urine output, and urine that is dark yellow or brown.

If you’re diagnosed with mono, you should increase your fluid level to 2-3 times the normal amount to help your body fight off the virus so you can recover more quickly.

3. Difficulty breathing

Your tonsils and lymph nodes may become enlarged if you have mono, which can lead to difficulty breathing and swallowing. If your breathing becomes too difficult, you should seek medical attention right away before lack of oxygen becomes a real danger.

You may also see an ear, nose, and throat (ENT) doctor to help with the swelling. Corticosteroids are often used to reduce the swelling so you can breathe, eat, and drink again.

If you’re fighting mono, Dr. Redlich and our team at A+ Athlete Sports Medicine can help. Call our Robbinsville or Neptune locations to schedule an appointment, or use online scheduling to book your visit today.