From the Research
The treatment for infectious mononucleosis (mono) primarily involves supportive care, as it is a viral infection that typically resolves on its own within 2-4 weeks. Rest is essential, particularly during the first week when symptoms are most severe. Adequate hydration and over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) at standard doses can help manage fever, sore throat, and body aches. Gargling with warm salt water (1/2 teaspoon salt in 8 ounces of water) several times daily may provide throat relief. Strenuous physical activity and contact sports should be avoided for at least 3-4 weeks to prevent potential splenic rupture, as the spleen often enlarges during mono. Alcohol should be avoided completely while recovering, as it can stress the liver which may already be affected by the virus. Corticosteroids like prednisone (40-60 mg daily for 5-7 days) may occasionally be prescribed for severe throat swelling that interferes with breathing or swallowing, as noted in 1. However, the use of steroids is not universally recommended and should be considered on a case-by-case basis, given the potential for adverse effects and the lack of strong evidence supporting their efficacy for symptom control in uncomplicated cases, as discussed in 2 and 3. Antibiotics are not effective against mono since it's caused by the Epstein-Barr virus, though they might be prescribed if a secondary bacterial infection develops. Most people recover completely with no long-term complications, though fatigue may persist for several weeks to months in some cases. The most recent review on the topic, 4, emphasizes the importance of supportive care and avoiding unnecessary investigations and treatments to minimize complications.
Some key considerations in managing mono include:
- Avoiding contact sports or strenuous exercise for 8 weeks or while splenomegaly is still present, as recommended in 4
- Ensuring adequate rest and hydration
- Using over-the-counter pain relievers as needed for symptom management
- Avoiding alcohol to prevent liver stress
- Considering corticosteroids for severe cases, but with caution and careful consideration of the potential risks and benefits, as discussed in 1 and 3.
Overall, the goal of treatment is to manage symptoms, prevent complications, and support the patient through the recovery process, with the understanding that most cases of mono will resolve on their own with time, as noted in 4 and 1.