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Infectious mononucleosis or “mono” is a viral infection of the throat usually caused by Epstein bar virus (EBV). It is often called “kissing disease” because it spreads through saliva. Mono is considered a disease of adolescents and young adults.

The symptoms of mono include fatigue, sore throat, malaise, swollen glands and lymph nodes, swollen tonsils, headache and rash. An enlarged spleen is a very important sign. The disease is usually self-limiting. Symptoms like sore throat and fever resolve in a couple of weeks but the fatigue and swollen glands last a bit longer.

The complications of infectious mononucleosis can be very dangerous, especially the enlargement of the spleen and the inflammation of the liver. Spleen of the mono patients is large and soft. Spleen is normally present in the upper left side of abdomen and even a minor blunt trauma in that region can cause a splenic rupture. A rupture can result in internal bleeding and severe pain. It is an emergency and needs immediate medical attention. 

That is one of the main reasons why the patients of mono are advised to avoid any type of sporting activity for at least a month.

Management of mono is mostly symptomatic, in fact, I’ll write the same line here that’s written in all the books of medicine; “The treatment of mono comprises of complete rest and adequate fluid intake”. Rest has a pivotal role in complete recovery from the disease. If you return to your normal routine to early, the chances of relapse increase; therefore it is necessary to take complete bed rest for at least a month.

Possible Causes Of Recurrence

Once the recovery is completed, most patients do not get mono again in their life. In some cases, however, the symptoms of mononucleosis may recur years later. This can happen for one of the following reasons:

  • Infectious mononucleosis is mostly caused by the Epstein Bar virus (EBV). Even after a complete recovery, your body will carry this virus for the rest of your life, but after that, this virus will be in its dormant form. The immune system of our body makes sure that the virus remains in its dormant and inactive form. In rare cases this virus is reactivated, especially when the person has weak immune system, for example during a period of extreme stress, strenuous physical activity or even a HIV infection. Any of these factors can result in the relapse of mono symptoms.
  • There’s another virus which can cause infectious mononucleosis. It’s called the Cytomegalo virus (CMV). It mostly results in the same symptoms as EBV. It is possible that you may have a CMV infection and your EBV is still in its dormant form.
  • Lastly, it is also possible that you don’t have mono this time. If you are experiencing only a single symptom of mono, for example fatigue, it may be due to general tiredness from your job or any other activity. If the fatigue is really effecting the quality of your life, you may have something called chronic fatigue syndrome. Get complete bed rest for some days and if the symptoms persist, take a doctor’s appointment.
  • Some other diseases like toxoplasmosis and hepatitis may also cause the same symptoms. 
The best thing to do here is consulting a doctor and get a complete workup to find out the exact cause.  

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