From the Guidelines
Infectious mononucleosis is typically treated with supportive care, as antiviral agents have no proven role in its treatment.
Treatment Overview
- The treatment of infectious mononucleosis primarily focuses on alleviating symptoms and managing complications, rather than targeting the underlying viral infection itself 1.
- Supportive care measures, such as rest, hydration, and pain management, are essential in helping patients recover from the illness.
- Corticosteroids may be considered in certain situations, such as airway obstruction or severe neurological complications, to reduce inflammation and swelling 1.
Antiviral Therapy
- Acyclovir and other antiviral agents have been studied for their potential role in treating infectious mononucleosis, but they have not been shown to provide significant benefits in otherwise healthy individuals 1.
- Immunosuppressive therapy should be discontinued in cases of symptomatic infectious mononucleosis, as it may exacerbate the condition 1.
Specific Considerations
- In patients with immunosuppression, such as those with inflammatory bowel disease, antiviral treatment may be necessary for other viral infections, such as HSV or VZV, but not for infectious mononucleosis itself 1.
- Plasma exchange and high-dose intravenous corticosteroids may be considered in rare cases of severe neurological complications, such as acute disseminated encephalomyelitis (ADEM) 1.
From the Research
Treatment for Infectious Mononucleosis
The treatment for infectious mononucleosis is mainly supportive, with a focus on relieving symptoms and managing complications. The following are some key aspects of treatment:
- 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
- Antiviral medications, such as acyclovir and valacyclovir, may be used to treat infectious mononucleosis, especially in cases with complications 3, 4
- However, the effectiveness of antiviral agents in treating infectious mononucleosis is uncertain, and the quality of evidence is very low 4
Management of Symptoms
The management of symptoms is an important aspect of treating infectious mononucleosis. This includes:
- Relieving fever and pain with over-the-counter medications such as acetaminophen or ibuprofen
- Managing sore throat and tonsillar pharyngitis with throat lozenges or gargling with salt water
- Relieving fatigue and promoting rest and recovery
Prevention
There is no licensed vaccine for the prevention of infectious mononucleosis, and avoiding exposure to EBV is almost impossible 2, 5. However, the development of an effective, safe, and affordable EBV vaccine that can confer life-long immunity is a potential strategy for preventing EBV infection and infectious mononucleosis 2.