Mono; Kissing disease
Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. The lymph nodes in the neck are frequently swollen and painful.
A pink, measles-like rash can occur and is more likely if you take the medicines ampicillin or amoxicillin for a throat infection. (Antibiotics should NOT be given without a positive Strep test.)
Symptoms of mononucleosis include:Less frequently occurring symptoms include:
During a physical examination, the doctor may find swollen lymph nodes in the front and back of your neck, as well as swollen tonsils with a whitish-yellow covering.
The doctor might also feel a swollen liver or swollen spleen when pushing on your belly. There may be a skin rash.
Blood work often reveals a higher-than-normal white blood cell (WBC) count and unusual-looking white blood cells called atypical lymphocytes, which are seen when blood is examined under a microscope. Atypical lymphocytes and abnormal liver function tests are a hallmark sign of the disease.
Hurt C, Tammaro D. Diagnostic evaluation of mononucleosis-like illnesses. Am J Med. 2007 Oct;120(10):911.e1-8.
Jenson HB. Epstein-Barr Virus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 251.