LYCOS RETRIEVER
Mononucleosis: Infections
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There is no cure for mononucleosis. But the good news is that even if you do nothing, the illness will go away by itself, usually in 3 to 4 weeks. Because mono is caused by a virus, antibiotics such as penicillin won't help unless you have an additional infection like strep throat. In fact, certain antibiotics can even cause a rash if you take them while you have mono.
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An EBV serologic profile is a series of blood tests that, if done and interpreted correctly, will provide a definite diagnosis of mononucleosis that is caused by EBV. Appearance of the antibodies specific for EBV proteins correlates with the stages of infection. The profile is highly accurate, but it is expensive. All physicians have access to laboratories that can perform these tests if they are necessary. The single most meaningful test result is the demonstration of immunoglobulin M (IgM) antibodies to EBV. This assay can be done several ways, but unfortunately some of the commercial test kits are overly sensitive and give false positive results.
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Antibiotics are ineffective against viruses, and they should not be prescribed for mononucleosis itself. Some patients with mononucleosis ... develop streptococcal (bacterial) throat infections, which should be treated with penicillin or erythromycin. Ampicillin (a form of penicillin) should not be used. When mononucleosis patients take ampicillin, 70 to 80 percent develop a rash for unknown reasons. Although not a true allergic reaction, the rash may be diagnosed as such, and the patient may be instructed unnecessarily to avoid penicillins in the future.
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The most effective treatment for mononucleosis is rest because a person's body needs time to fight off the infection. Individuals with mild cases may not require bed rest, but they should restrict their physical activity. In any case, vigorous physical activity, such as athletics or heavy lifting, should be avoided. Such activities can cause the spleen to rupture, making the condition much more serious.
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Occasionally, a streptococcal (strep) infection accompanies the sore throat of mononucleosis. You may ... develop a sinus infection or an infection of your tonsils (tonsillitis). If so, you may need treatment with antibiotics for these accompanying bacterial infections.
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It may not be possible-or even useful-to distinguish between infectious mononucleosis caused by EBV infection and an infectious mononucleosis-like syndrome caused by toxoplasmosis or CMV, because the management of these syndromes is the same. However, diagnostic testing is warranted in pregnant women because toxoplasmosis and acute human immunodeficiency virus (HIV) and CMV infections are associated with significant pregnancy complications.
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