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Question : My 14-year-old son was diagnosed with mono seven months ago. He is still very fatigued and his spleen remains slightly enlarged. His doctor says it will just take time. Is there anything he can do besides wait? Isn't seven months a long time to recover?
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The Trusted Source
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Howard LeWine, M.D.

Anthony L. Komaroff, M.D., is professor of medicine and editor-in-chief of Harvard Health Publications at Harvard Medical School. Dr. Komaroff also is senior physician and was formerly director of the Division of General Medicine at Brigham and Women's Hospital. Dr. Komaroff has served on various advisory committees to the federal government, and is an elected Fellow of the American Association for the Advancement of Science.

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February 07, 2014
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Mono (the full name is “infectious mononucleosis”) is caused by a viral infection. Most often it is caused by the first infection a child, teenager or young adult gets with the Epstein-Barr virus. Unlike many other common viral infections (such as the common cold or gastroenteritis), mono is often a prolonged illness.

In the first week or two of the illness, people are pretty sick. They have high fevers, severe fatigue, aching muscles and very swollen glands in the neck, under the arms, in the groin and elsewhere. After one to two weeks, most people slowly begin to feel a little stronger. Some are able to return to school or work even though they are still not completely recovered.

A few people recover completely in three to four weeks. And most people recover in two to three months. But in some people the illness may last for six to 12 months or even longer. It appears that it takes their immune systems longer to control and quiet the viral infection. Why this is, though, we don’t know.

Unfortunately, no treatment has been proven to speed recovery from mono. I agree with his doctor: It just takes time.

A gradually increasing aerobic exercise program might help. But your son should not engage in any kind of activity (such as contact sports) that could cause an injury to his abdomen. The spleen sits in the upper left part of the abdomen. Mono can cause the spleen to become enlarged, and it can rupture if it is hit. A ruptured spleen is a serious condition that can require emergency surgery.

If your son is not back to normal after 12 months, that would be quite unusual. In that case, it might be worth having an infectious disease specialist see him. He or she can perform tests to see which virus might be causing the condition and whether an anti-viral drug could help.

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