Mononucleosis is rare in adults as most were infected as children. Symptoms include fatigue, sore throat, fever, enlarged lymph nodes and spleen. Diagnosis involves blood tests and patient history. Treatment is aimed at reducing symptoms and recovery time can be prolonged. Mono can cause liver damage, but this is rare. Other medical conditions can mimic mono symptoms.
Mononucleosis in adults is uncommon because most adults were infected with the virus when they were children. The virus that causes mononucleosis is called the Epstein-Barr virus and can remain dormant for years. Although the symptoms of mononucleosis are similar for young adults and adolescents, they can be markedly more severe and persistent in adults.
Typical symptoms of infectious mononucleosis, sometimes known as kissing disease, are pronounced fatigue, sore throat and fever. Also, the patient may experience enlarged cervical lymph nodes and enlarged spleen. When the spleen is enlarged, patients should avoid lifting or playing sports because a ruptured spleen can be life-threatening.
Diagnosing mononucleosis in adults involves doing blood tests to determine the presence of the Epstein-Barr virus and examining the patient. Also, the doctor will take a thorough patient history to determine if they have been exposed to someone with mono or Epstein-Barr virus. It is important to note that the presence of Epstein-Barr virus in the blood does not constitute a definitive diagnosis of mononucleosis.
Typically, the treatment for mono in adults is the same as for young people. Treatment is aimed at reducing symptoms and includes pain and fever medications, adequate rest, and plenty of fluids. Adults should consult their doctor before taking aspirin for mono, especially if they are taking blood thinning medications.
Recovery time is sometimes prolonged in cases of mononucleosis in adults. Generally, in younger people, the symptoms of mononucleosis begin to subside after two weeks, however, in adults, this can take months. Since mono is a viral infection, antibiotics are ineffective in speeding up the recovery process, as they are only effective in treating bacterial infections.
Although mononucleosis in adults is not as common as in adolescents and children, adult patients are more likely to experience enlarged liver, increased liver enzymes, and jaundice. When the liver is affected by the Epstein-Barr virus, it can cause yellowing of the skin and the whites of the eyes and very dark urine. Jaundice is commonly caused by increased circulating blood levels of a chemical called bilirubin.
Because mono in adults is uncommon, your doctor might rule out other causes before a diagnosis of mono is made. Other medical conditions that have mononucleosis-like symptoms include hepatitis, cirrhosis of the liver, and gallbladder disease. Also, viral and bacterial infections can mimic the symptoms of mononucleosis. Fortunately, mononucleosis in adults rarely causes long-term liver damage, but it can happen. When the liver enzyme elevation is resistant to treatment, the patient may be referred to a liver specialist for further evaluation and treatment.
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