From the Research
The primary approach to managing mononucleosis in a toddler is supportive care, as there is no specific antiviral treatment for this Epstein-Barr virus infection. Focus on ensuring adequate hydration with frequent small sips of fluids, managing fever with acetaminophen (10-15 mg/kg every 4-6 hours, not exceeding 5 doses in 24 hours) or ibuprofen (5-10 mg/kg every 6-8 hours with food for children over 6 months) 1. Ensure the child gets plenty of rest while the immune system fights the infection. Avoid aspirin due to the risk of Reye's syndrome. Throat pain can be managed with cold fluids, popsicles, or honey (for children over 12 months). Most toddlers recover within 2-4 weeks, though fatigue may persist longer. Some key points to consider in management include:
- Contact a healthcare provider immediately if the child shows signs of severe throat swelling, difficulty breathing, severe abdominal pain, or extreme lethargy.
- Complications are rare in toddlers, but the spleen may become enlarged, so avoid rough play or contact sports for at least 3-4 weeks to prevent splenic rupture 1.
- Corticosteroids should be reserved for those with impending airway obstruction, autoimmune complications, or other severe circumstances, as current evidence points to small and inconsistent benefits when using corticosteroids for symptom relief in children with IM 2. It's also important to note that while some studies suggest nonsteroidal anti-inflammatory drugs (NSAIDs) may quickly resolve symptoms associated with EBV-induced infectious mononucleosis in patients with atopic predispositions 3, the primary approach remains supportive care, with a focus on hydration, rest, and symptom management.