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Forum Name: Other infections

Question: Help! Could this still be mono?


 amyswag1 - Tue Mar 15, 2005 9:57 am

My 13 year old daughter has not been feeling well since last Saturday, 3/5/05 ~ sore throat, fever (low 99-100) that is on and off, extreme fatigue, headache, upset stomach, and constantly complaining of feeling dizzy. She stayed home from school on Monday the 7th, went to school on the 8th but had to come home early. I took her to the dr. that day and they thought she had mono. They did labs and sent us home with Zithromax. She did not go to school the rest of the week and continued to be ill over the weekend with the same complaints as above with the exception of the fever seemed to be more “on” than “off”. I took her back to the doctor on Monday the 14th and was told that her labs were positive for a past mono infection within the last 2-3 months but nothing current. They indicated her labs were also positive for allergies. They said that she should be fine and with the exception of her allergies “acting up” i.e. ears looked fine, throat looked ok, etc.. They gave her Singular, Rhinocort, another round of Zithromax and gave her a shot of something. I’m guessing a steroid but they didn’t say. I should have asked.

I guess my question is……could she have the mono now even though the labs reported a past positive? She has been feeling great up until last week…..hasn’t been sick at all! Which is uncommon for her because she, historically, seems to have a weakened system (pneumonia x2, scarlet fever x2, numerous ear infections, etc). Now she can hardly get off the couch, is still running a fever and is constantly crying about not feeling good.

Pleas help!
 Dr. Heba Ismail - Wed Mar 16, 2005 12:03 pm

Dear amyswag1,
Infectious mononucleosis (often called "mono") is a common viral infection that causes fever, sore throat, and enlarged lymph nodes. Mono is commonly caused by the Epstein-Barr virus, in more than 90% of cases, but other viruses, such as cytomegalovirus (CMV), can also cause mono.
Once infected with one virus, a person develops lifelong immunity to future infections by the same virus, but not to other types of viruses causing mono.
Mono can also be mixed up with other serious conditions, but that can usually be excluded by simple lab tests as a blood count and an ESR. If you haven't had them done, please discuss this with your doctor.
If the condition proves to be mono, I'd like to assure you that it generally goes away without medical help. However, it may last from weeks to months. Treatment is mainly to ease symptoms, usually at home, with plenty of rest and fluids, acetaminophen or ibuprofen for fever and pain control.
Schedule routine visits with your doctor, so he/she can monitor the course of the illness and detect possible complications.
If her condition worsens at any time, do not hesitate to take her immediately to the hospital.
Please keep us informed with what's going on.
 amyswag1 - Wed Mar 16, 2005 12:18 pm

Thank you so much for your reply! My daughter did have labs done for mono and they came back positive for a past infection 2-3 months prior. However, she has not been ill in the past six months so I was wondering if she could be experiencing the symptoms of mono now even though the lab results say she currently does not have mono. Does that make any sense?
 Dr. Heba Ismail - Wed Mar 16, 2005 3:39 pm

Dear amyswag1,
I apologise for not making myself clear.
A previous infection with mono may sometimes pass unnoticed clinically, and would only appear a few months later in lab results.
Since the Epstein-Barr virus is the common cause for mono, it is the virus usually tested for, while other viruses are not, and the test is usually referred to as the test for mono, which is of course a misnomer! It could be misleading, as in your daughter's case, where she has a picture of mono now, but negative labs for a current infection.
However, I need to know if also a blood picture and ESR were done or not? The picture of mono could sometimes be mistaken with other serious problems and we need to rule them out!

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