What Is Chronic Mononucleosis?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 09 August 2019
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Chronic mononucleosis is an Epstein-Barr virus infection that remains active for more than six months. During this period, the patient can feel fatigued, feverish, and weak. It usually resolves after several months, although some cases may last for years. Evaluation of patients diagnosed with chronic mononucleosis shows that some actually have other conditions. It is important to receive a thorough evaluation when this diagnosis is suspected, to confirm it and determine if the recommended course of treatment is appropriate.

The Epstein-Barr virus is quite common, and many people are exposed to it early in childhood. Some people develop infectious mononucleosis in their teens if they haven’t had the infection earlier in life. Patients carry the virus with them, and may experience periodic recurrences when their immune systems are low or they are stressed. In rare cases, the virus remains active for six months or more, causing continuing symptoms, rather than going latent after causing the initial infection.

Patients with chronic mononucleosis can have all the symptoms of an active infection, including sore throat, coughing, and extreme fatigue. The fever can make it hard to concentrate or perform tasks, while weakness and fatigue may limit the patient’s activity levels. Treatments can include pain management medications, antiinflammatory drugs, and rest to help the patient recover. Some people need to take time off from work or school because they have trouble staying awake through the day or can’t do their work effectively.


In cases where a patient may have chronic mononucleosis, a lab test can confirm the presence of an active Epstein-Barr infection. If this infection is not present, the patient has another condition. One possible cause of the symptoms is Chronic Fatigue Syndrome (CFS). Cases of CFS can appear similar to chronic mononucleosis in onset; the patient experiences flu-like symptoms, feels very unwell, and develops intense fatigue that persists despite rest and treatment.

Other conditions can also cause symptoms like fever and fatigue. When there is no presence of Epstein-Barr infection, the doctor may request some additional testing to rule out other options before considering CFS. The patient might have leukemia, for example, which sometimes begins with extreme tiredness and fever. Testing can determine the specific cause of the symptoms, which may have a substantial impact on treatment recommendations. Patients should make sure to discuss their symptoms in detail, even if issues don’t appear specifically related, because they might provide important clues for the doctor.


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