The wide range of symptoms associated with mononucleosis can make diagnosis difficult. Your doctor will begin by giving you a complete physical exam. A throat culture may be taken to rule out strep throat, which has similar symptoms. The doctor may take a blood sample to look for the presence of abnormal white blood cells.
A heterophile antibody test, commonly called a “Monospot,” may also be done. This test examines the blood for special antibodies that your body produces in response to a viral infection in an effort to fight it off. This test isn’t always accurate, especially in younger children, and it takes several days for it to become positive after a child starts to feel ill.
Scarlet fever most often occurs in children. Its symptoms may include:
Bright red or scarlet spotty rash, usually beginning on the neck or chest (often excludes face, palms, and soles of the feet)
Sore throat (although half of patients will not have this symptom)
Tongue with white coating and red bumps -- referred to as strawberry tongue
Swollen glands in neck
The results of these tests are not always clear, however, and additional tests may be needed. Time is required for the body to produce antibodies, so a blood test done on the third day of illness, for instance, may be negative -- while another blood sample drawn a week later may test positive.
Most people recover from mononucleosis within two weeks. So the primary prescription for mono is complete bed rest with a gradual return to normal activity. Because the spleen, an organ in the abdomen, is often enlarged with mononucleosis infection, it's at a greater risk of being ruptured. Contact sports such as football and soccer should be avoided at least for several weeks.
In addition to bed rest, your doctor may prescribe ibuprofen or acetaminophen for the fever, sore throat, and other discomforts of the illness. Because of possible liver involvement, check with your doctor about using acetaminophen.
Do not give aspirin to children. Aspirin should be avoided because it has been associated with a disease called Reye's syndrome, a serious illness that can lead to death.
If your sore throat is so severe that you have trouble breathing or eating, your doctor may give you prednisone, a steroid drug.
How Can I Prevent Mononucleosis?
Most people will come in contact with the virus that causes mononucleosis at some point in their lives, so there is no sure way to prevent catching mononucleosis. But keeping your immune system strong with rest, exercise, and diet may play a role in keeping you from becoming very ill from the illness.