From the Guidelines
Infectious mononucleosis, also known as mono or glandular fever, is primarily managed with supportive care to alleviate symptoms, as there is no specific cure for the virus 1.
Key Recommendations
- Rest and hydration: Rest and avoiding strenuous activities for at least 4 weeks to prevent complications such as splenic rupture, and staying hydrated by drinking plenty of fluids, such as water, clear broths, and electrolyte-rich beverages like sports drinks.
- Pain management: Taking over-the-counter pain relievers like acetaminophen (500-1000 mg every 4-6 hours) or ibuprofen (200-400 mg every 4-6 hours) to help manage fever, headache, and sore throat.
- Throat care: Gargling with salt water several times a day to soothe a sore throat.
- Activity modification: Avoiding contact sports or heavy lifting to reduce the risk of splenic rupture.
- Corticosteroids: Considering corticosteroids like prednisone (40-60 mg per day for 5-7 days) if there are complications such as significant swelling of the throat or severe autoimmune hemolytic anemia, under the guidance of a healthcare provider 1.
- Monitoring: Monitoring for potential complications, such as an enlarged spleen, and seeking immediate medical attention if symptoms worsen or if there are signs of severe illness, such as difficulty breathing, severe abdominal pain, or vomiting. It's essential to note that antiviral agents, such as acyclovir, have no proven role in the treatment of infectious mononucleosis in otherwise healthy individuals 1.
From the Research
Treatment Overview
The treatment for Infectious Mononucleosis is mainly supportive, focusing on managing symptoms and preventing complications 2, 3, 4, 5.
Supportive Care
- Reduction of activity and bed rest as tolerated are recommended 2
- Patients should be advised to avoid contact sports or strenuous exercise for 8 weeks or while splenomegaly is still present 2
- Adequate analgesia is provided for symptom relief 3
Medical Management
- Corticosteroids are indicated for patients with upper airway obstruction 3
- Corticosteroids may be helpful in patients with neurologic, hematologic, or cardiac complications 3
- Acyclovir may prove to be useful, but further studies are needed before its use can be recommended 3
- Steroids have been used for their anti-inflammatory effects, but there are no universal criteria for their use 6
Symptom Relief
- Symptom relief and rest are commonly recommended treatments 6
- Steroids have been found to reduce sore throat at 12 hours in some trials, but the benefit was not maintained 6
- In combination with an antiviral drug, participants in the steroid group had less pharyngeal discomfort between days two to four 6