Saturday 14 June 2008

severe infectious mononucleosis

Hello:My daughter is 7 and has been diagnosed with mono. She started with a low grade temp for 12 days off and on. Then she got the "bad attack". She has had high temps for the last 5 days. They get up to 104.5-105.4 if I am not giving her tylenol and/or ibuprofen every 4-6 hours. Her spleen is swollen, tonsils are very swollen, bad headache and in bed for 5 days. Yesterday she had difficulty even walking because of weakness. It is my understanding that children this age typically do not get mono this bad. Will this last longer for her because of the severity of her symptoms and how long should she have this high fever? She is also taking codeine for the pain. Thank you for any information you can offer me. Leanne.

Dear Leanne,
You are correct, the younger the sufferer of mono the milder it is in most cases. This usually means that children under 6 do not have the diagnosis made although they certainly do catch it.
I presume your doctor has confirmed the diagnosis and a blood test has been taken.
I guess there are always exceptions to the rule. I don't think she will have an unusually long course because it is so severe - this is based on my own observations and I am not aware of any proper scientific study that has measured length of illness against severity in mono.
I would not base the giving of Tylenol on the presence of fever but more on whether she is in pain or not. Fever is one of the body's defences against viral infection, which mono is. Temperatures around 105 are rare in adults but quite common in children.
Regrettably, there is little modern medicine can do to help your daughter to overcome mono but she will recover.
David Robinson

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