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Infectious Diseases

RE: Mononucleosis

11/27/2006

Question:

My son was diagnosed with mono in September 2005 and spent 5 weeks of down time, until blood tests indicated he could continue with hockey at a competitive level. Then throughout April, May and June of this year he has experienced periods of fatigue and low grade fevers.

Recently he is feeling unwell with sore throat, bumps on his tongue, occasional night sweats and fatigue and a cough. Is it possible that a person can relapse with mono or once you have it are you immune? Could he be suffering from a chronic illness due to that virus?

Answer:

Infectious mononucleosis is caused by Epstein-Barr virus (EBV) which is a member of the herpes virus family. Most of the herpes viruses cause latent infections and, as such, have the potential for relapse. For example, you are probably familiar with "cold sores" caused by herpes simplex virus. These will often return repeatedly during a person's life time. It has been suggested that EBV may be responsible for recurrent fatigue in young and middle-aged adults in an illness known as "chronic fatigue syndrome." Rigorous scientific studies, however, have failed to show a real link between EBV and this illness. Most individuals only have acute mononucleosis once.

Rarely, EBV can cause ongoing and persistent infections. This is a condition that can be diagnosed through further laboratory testing. Furthermore, there are may be many other causes of your son's symptoms. If these symptoms persist you should have him reevaluated by your personal physician. If there are concerns about recurrent EBV or other infections, a consultation with an infectious diseases specialist would be advisable.

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Response by:

Kurt B Stevenson, MD, MPH Kurt B Stevenson, MD, MPH
Professor of Infectious Diseases
College of Medicine
The Ohio State University