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Mononucleosis in adults is not common because most adults have been infected with the virus when they were children. The virus that causes mononucleosis is called the Epstein-Barr virus, and it can remain dormant for years. Although symptoms of mono are similar for young adults and adolescents, they can be markedly more severe and tenacious in the adult.
Typical symptoms of infectious mononucleosis, sometimes known as the kissing disease, are pronounced fatigue, sore throat, and fever. In addition, the patient may experience enlarged cervical lymph nodes and spleen enlargement. When the spleen is enlarged, patients need to avoid lifting or playing sports because a ruptured spleen can be life threatening.
Diagnosing mononucleosis in adults involves performing blood tests to determine the presence of the Epstein-Barr virus and making a physical examination of the patient. In addition, the physician will take a thorough medical history from the patient to determine if he has been exposed to anyone with mono or the Epstein-Barr virus. It is important to note that the presence of the Epstein-Barr virus in the blood does not make a definitive diagnosis of mononucleosis.
Typically, treatment for mononucleosis in adults is the same as for young people. Treatment is aimed at reducing symptoms and includes pain- and fever-educing medications, adequate rest, and plenty of fluids. Adults should consult their physicians before taking aspirin for mono, especially if they are receiving anticoagulant drugs.
Recovery time is sometimes prolonged in cases of mononucleosis in adults. Generally, in younger people, symptoms of mononucleosis begin to subside after two weeks, however, in adults, this can take months. Since mono is a viral infection, antibiotics are ineffective in hastening the recovery process, as they are only effective in treating bacterial infections.
Although mononucleosis in adults is not as common as it is in adolescents and children, grown patients are more likely to experience liver enlargement, elevated liver enzymes, and jaundice. When the liver is affected by the Epstein-Barr virus, it can cause yellowing of the skin and whites of the eyes and cause the urine to become very dark. Jaundice is commonly caused by the elevation in circulating blood levels of a chemical called bilirubin.
Since mononucleosis in adults is not common, the physician might rule out other causes before a diagnosis of mono is made. Other medical conditions that have symptoms similar to mononucleosis include hepatitis, cirrhosis of the liver, and gallbladder disease. In addition, viral and bacterial infections can mimic the symptoms of mononucleosis. Fortunately, mononucleosis in adults rarely causes long-term liver damage, however, it can occur. When liver enzyme elevation is resistant to treatment, the patient may be referred to a liver specialist for further evaluation and treatment.