Infectious mononucleosis, often referred to as “mono,” is a common viral infection. The Epstein-Barr virus (EBV) most frequently causes mono, though other viruses can also be responsible. This infection is particularly prevalent among teenagers and young adults. It spreads readily through saliva via close contact, earning its nickname, “the kissing disease.”
Throat Manifestations of Mono
A sore throat is a prominent symptom of mononucleosis, and its appearance can offer clues about the infection. The tonsils and surrounding throat tissues often become red and noticeably swollen. This inflammation can be quite intense, making swallowing uncomfortable.
A characteristic feature of a mono-affected throat is the presence of white or grayish-green patches, known as exudates, on the tonsils. These patches can resemble the exudate seen in strep throat, leading to potential misdiagnosis. The tonsils themselves can become significantly enlarged, sometimes swelling to the point where they nearly touch in the back of the throat, a condition referred to as “kissing tonsils.” This severe swelling can make both breathing and swallowing challenging.
Another distinctive sign is the appearance of small, pinpoint red spots called petechiae on the soft palate. These tiny red spots result from minor bleeding under the surface. While these throat symptoms are highly suggestive of mono, they can overlap with other conditions, emphasizing the need for medical evaluation for an accurate diagnosis.
Other Common Signs and Symptoms
Mononucleosis presents with a range of other symptoms. Extreme fatigue is a hallmark of mono, often described as profound and prolonged, and it can persist for several weeks or even months after other symptoms resolve. A fever, typically ranging from 100°F to 103°F (37.8°C to 39.4°C), is also common, often being most severe during the first week of the illness.
Swollen lymph nodes are observed, particularly in the neck, but they can also affect the armpits and groin. Individuals with mono may experience general discomfort, including headaches and muscle aches. A skin rash can develop, appearing as a pink, measles-like eruption, especially if certain antibiotics like ampicillin or amoxicillin are taken while infected with EBV.
The spleen, an organ in the upper left abdomen, may become enlarged (splenomegaly) in up to half of mono cases. The liver can also be affected, with mild inflammation (hepatitis) or, less commonly, a yellowish discoloration of the skin and eyes (jaundice). While these internal organ changes are usually detected during a medical examination, an enlarged spleen can sometimes cause abdominal discomfort or a feeling of fullness.
When Medical Consultation is Recommended
Seeking medical attention for suspected mononucleosis is important for diagnosis and management, especially because its symptoms can mimic other conditions like strep throat. A healthcare provider can conduct a physical examination and may order blood tests to confirm the diagnosis and rule out other illnesses. Early diagnosis helps ensure appropriate care and can prevent potential complications.
Certain symptoms warrant immediate medical consultation. These include severe throat swelling that causes difficulty breathing or swallowing liquids, as enlarged tonsils can obstruct the airway. Extreme or sharp abdominal pain, particularly in the upper left side, requires urgent attention because it could signal a rare but serious complication, such as a ruptured spleen. Persistent high fever, worsening symptoms, inability to drink fluids due to dehydration risk, or the development of yellow eyes or skin (jaundice) are also reasons to contact a doctor promptly. It is particularly important for very young children or individuals with compromised immune systems to receive medical evaluation due to potentially different symptom presentations or increased risk of complications.