From the Research
Recurrent infectious mononucleosis should be managed with supportive care, including adequate rest, hydration, and use of acetaminophen or ibuprofen for fever and pain relief, as there is no specific antiviral therapy approved for Epstein-Barr virus (EBV) 1.
Key Considerations
- Patients should prioritize rest and maintain hydration to help manage symptoms.
- Acetaminophen or ibuprofen can be used for fever and pain relief.
- In severe cases with significant fatigue, a gradual return to normal activities over several weeks may be recommended.
- Antiviral medications like valacyclovir may be considered for persistent or recurrent symptoms, although evidence for their effectiveness is limited 2.
- Corticosteroids such as prednisone may be prescribed for complications like severe throat inflammation or airway obstruction.
Preventing Complications
- Patients should avoid contact sports and strenuous physical activity until fully recovered to prevent splenic rupture, a rare but potentially fatal complication of infectious mononucleosis 3, 4.
- Alcohol consumption should be limited as it may stress the liver, which is often affected by EBV.
Further Investigation
- Recurrent mono may indicate an underlying immune dysfunction, so persistent symptoms warrant further investigation to rule out other conditions like chronic active EBV infection or immune deficiencies 1.
- EBV-specific antibody profiles can be used to stage EBV infection and guide further management.