Infectious mononucleosis, commonly known as mono, is a widespread viral infection. It is most often caused by the Epstein-Barr virus (EBV), a member of the herpesvirus family, though other viruses can also cause similar symptoms. Typical symptoms include fatigue, fever, a sore throat, and swollen lymph nodes in the neck. For the majority of individuals, mono is a self-limiting illness, meaning the body’s immune system fights off the infection, leading to recovery within weeks to months.
Fatalities are Rare
Fatalities from infectious mononucleosis are extremely uncommon. Millions contract mono annually, but deaths remain exceptionally low, often reported as isolated cases. Mono is not considered life-threatening for healthy individuals. The prognosis is favorable, with most recovering without long-term complications.
Causes of Severe Outcomes
Though mono is typically benign, rare complications can lead to severe outcomes. One such complication is splenic rupture, occurring in 0.1% to 0.2% of cases. The spleen often enlarges during infection, making it susceptible to rupture from physical trauma or spontaneously. Splenic rupture can cause internal bleeding and is considered a medical emergency. Another rare complication is severe upper airway obstruction, caused by swollen tonsils and lymph nodes that block the throat, making breathing difficult.
Neurological complications, though infrequent, can arise from mono. These include encephalitis (brain inflammation) or meningitis (inflammation of membranes surrounding the brain and spinal cord). Guillain-Barré syndrome, where the immune system attacks nerves, is also linked to EBV.
Blood disorders like hemolytic anemia (red blood cell destruction) or thrombocytopenia (low platelet count) can also occur. Rarely, myocarditis (heart muscle inflammation) can occur. Immunocompromised individuals, such as those with HIV/AIDS or organ transplant recipients, face a higher likelihood of severe EBV manifestations.
Preventing Serious Complications
Preventing serious complications centers on careful management. Adequate rest and hydration support recovery. To prevent splenic rupture, avoid strenuous physical activities, heavy lifting, and contact sports for at least one month after symptoms begin. This precaution helps protect the enlarged spleen from potential injury.
Seek prompt medical attention if symptoms worsen or unusual signs appear, such as sharp abdominal pain, difficulty breathing, severe headaches, or significant muscle weakness. For severe airway obstruction, corticosteroids may reduce swelling. Most cases resolve without intervention, but monitoring and timely medical consultation manage potential complications effectively.