Infectious Mononucleosis: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Infectious Mononucleosis?
A primary care doctor, such as a family medicine doctor, often diagnoses and treats mono. An infectious disease doctor, who treats infections, may help with harder cases. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is infectious mononucleosis?
Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck. It is also called the kissing disease or glandular fever. Mono is caused by the Epstein-Barr virus, or EBV. Rarely, other viruses such as cytomegalovirus (CMV) cause it. EBV is one of the most common human viruses in the world. Most people get infected in their lifetime, often as children, and have no symptoms.
Symptoms
Mono may begin slowly with tiredness, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. The tonsils swell and get a whitish-yellow covering. The lymph nodes in the neck are often swollen and painful. Common symptoms include:
- Fever.
- Drowsiness.
- Loss of appetite.
- Muscle aches or stiffness.
- Sore throat.
- Swollen lymph nodes, most often in the neck and armpit.
A pink, measles-like rash can occur. The rash is more likely if you take the medicine ampicillin or amoxicillin for a throat infection. An enlarged spleen and a swollen liver can also happen.
Causes and who gets it
Mono is often spread by saliva and close contact. It occurs most often in teens and young adults, but it can happen at any age. EBV spreads most often through saliva by kissing, sharing drinks and food, and sharing cups, utensils, or toothbrushes. It can also spread through blood and semen during sex, blood transfusions, and organ transplants. People with mono may be contagious while they have symptoms and for up to a few months afterwards. There is no vaccine to protect against EBV infection.
How doctors diagnose it
A doctor will examine you and may find swollen lymph nodes in the neck, swollen tonsils, a swollen liver or spleen, or a skin rash. Diagnosing EBV infection can be hard because the symptoms are like those of other illnesses. Blood tests include a white blood cell count, which will be higher or lower than normal if you have mono. A Monospot test will be positive for mono. An antibody titer tells the difference between a current and a past infection.
Treatment
The goal of treatment is to relieve symptoms. There is no specific treatment for EBV. Antiviral medicines, such as acyclovir, have little or no benefit. A doctor may prescribe a steroid medicine if symptoms are severe. Doctors usually give antibiotics only after a test shows a strep or other bacterial infection. To feel better, drink plenty of fluids and get plenty of rest.
Gargling with warm salt water can ease a sore throat. Acetaminophen or ibuprofen can help with pain and fever. Avoid contact sports if your spleen is swollen, to prevent it from rupturing. Most people get better in 2 to 4 weeks. Tiredness usually goes away within a few weeks, but it may linger for 2 to 3 months. Nearly everyone recovers completely. Rarely, the spleen can rupture, which means it tears open.
When to see a doctor
The early symptoms of mono feel much like any other virus. You do not need to contact a provider unless your symptoms last longer than 10 days or you develop certain warning signs.
- Persistent high fevers.
- Severe headache.
- Severe sore throat or swollen tonsils.
- Yellow color in your eyes or skin.
Call 911 or the local emergency number or go to an emergency room if you develop sharp, sudden, severe abdominal pain, a stiff neck or severe weakness, or trouble swallowing or breathing.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A doctor in one of these practices can examine you, order blood tests, and help you plan rest and follow-up. They can also tell you when to see a specialist or go to the emergency room.
Common questions
How long does mono last?
Most people get better in 2 to 4 weeks. Tiredness may linger for 2 to 3 months.
Is mono contagious?
Yes, people with mono may be contagious while they have symptoms and for up to a few months afterwards. Avoid kissing or sharing utensils if you or someone close to you has mono.
Can mono cause a rash?
Yes, a pink, measles-like rash can occur. It is more likely if you take ampicillin or amoxicillin for a throat infection.
Is there a vaccine for mono?
No, there is no vaccine to protect against EBV infection. You can help protect yourself by reducing contact with people who have EBV infection.
Can I play sports with mono?
You should avoid contact sports if your spleen is swollen. This helps prevent the spleen from rupturing.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
