Suspecting Mono in Your Teenager

November 21, 2009

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Suspecting Mono in Your Teenager

by Lynn Cates, M.D., F.A.A.P.
reviewed by Laura Jana, M.D., F.A.A.P.

Mono traditionally has been associated with the teen years because that is when the classic--and fairly dramatic--symptoms are most likely to occur. Actually, however, only about a third to half of teens and adults with mono develop a full-blown case of infectious mononucleosis; the rest simply present with fever and other symptoms that look much the same as other viral illnesses. Following is a list of symptoms and other indicators that increase the likelihood that your teen may have mono.

Classic symptoms
You should strongly suspect the possibility of mono if your child develops a combination of symptoms that includes fever, sore throat, and swollen lymph glands.

Fever. A temperature of 102 degrees Fahrenheit or more often is present and may last as long as a week or two.

Sore throat. Not only do the throat and tonsils appear red, but many times (in about 50 percent of cases) the tonsils have white spots (pus) on them as well.

Swollen lymph nodes. Enlarged lymph nodes (also known as lymph glands) may be seen in the groin or under the arms, but are most commonly found in the neck. They may be tender to the touch.

Other indications your child may have mono

Prolonged viral illness. If your teenager develops what seems like a routine viral illness--such as cold or flu symptoms, aches, or fever--that drags on longer than a few days, mono is a possibility.

Prolonged strep throat. Mono can mimic the symptoms of strep throat, and a person can have both mono and strep at the same time. So, if your teen is treated for strep throat but doesn't start feeling better within a couple of days, mono could be responsible.

Rash with ampicillin. Most adolescents and adults (but not as many young children) with mono develop a rash when given ampicillin (or it's more commonly known derivative, amoxicillin). Usually the rash associated with this type of antibiotic is not related to mono, but if it develops, you may want to inquire with your teen's practitioner about the possibility of mono.

Fatigue. The degree of fatigue can vary quite a bit and may be extremely pronounced at this age. If your teenager's level of fatigue seems out of proportion to his other symptoms, he may have mono.

Exposure to mono. If he develops fever and flu-like symptoms after being around someone who has mono, particularly if his symptoms don't resolve fairly promptly, you should suspect mono.

Nonspecific symptoms
Other symptoms that may accompany mono include:

Jaundice. Jaundice, or yellow coloring of the skin and the whites of the eyes, suggest an inflammation of the liver (hepatitis), which sometimes is seen with mono.

Gastrointestinal symptoms. It's not uncommon for a person who has mono to have a poor appetite, nausea, vomiting, or diarrhea, especially if he also has hepatitis.

Other symptoms. Your teen also may complain of general weakness, headache, stiffness, and sore muscles. Since mono can affect any organ, almost any symptom is compatible with a diagnosis of mono.

When to seek advice
The majority of teens who get mono don't suffer from severe symptoms and recover completely within a month. However, if you suspect your teen might have this disease, you still should consult with his healthcare provider, since mono can occasionally cause serious complications. The combination of fever, sore throat, and swollen lymph nodes should definitely prompt a call for advice, especially if he has been exposed to mono.

If the diagnosis is confirmed, he should be monitored until he has returned to normal. Unfortunately, there is no specific treatment for mono; in general, doctors recommend plenty of rest and taking over-the-counter medications for fever and pain relief.

An important final note: If your child develops sharp or severe pain in the left part of his abdomen, seek help immediately, because this may be a sign of a ruptured spleen, which needs urgent surgical treatment.


RELATED INFORMATION

			Fever: Overview
			Strep Infections: An Overview
			Mononucleosis

Created June 17, 2001
Reviewed June 21, 2005

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