Stephen J. Schueler, M.D.

Overview Incidence Symptoms Evaluation Treatment questions for doctor Home Care congestion in adults congestion in children pain and fever adults pain and fever children warning signs Underlying Cause Types

Epstein Barr Virus Home Care

Home care for Epstein Barr infection includes:

Epstein Barr Virus Congestion in Adults

Home treatment measures for congestion in adults with an Epstein-Barr infection include general measures and medications. Medications include oral decongestants, decongestant nasal sprays and antihistamines.

General Measures

  • Blow your nose gently. Forceful blowing can cause pain and bleeding.
  • Apply petroleum jelly to the nostrils if the skin becomes dry.
  • Drink plenty of liquids.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Use saline (saltwater) nose spray, such as Ocean Nasal Mist: saline helps to keep the lining of nasal passages moist. Saline may be used to flush the nasal passages:
    • Lie on your back and tilt your head back.
    • Apply 2- 4 drops of saline in one on nostril, then wait 1 minute.
    • Blow your nose.
    • Repeat in the other nostril.

Oral Decongestants
Oral decongestants, such as pseudoephedrine (Sudafed), help to thin the mucus responsible for the congestion. Decongestants are safe for adults and adolescents.

Precautions include:

Decongestant Sprays
Decongestant nasal sprays, such as pseudoephedrine (Afrin) can relieve congestion faster than oral medications.

Examples include:
  • Afrin Nasal Spray
  • Duration Nasal Spray
  • Four-Way Fast Nasal Spray
  • Neo-Synephrine Nasal Spray
  • Vicks Sinex Nasal Spray

Precautions include:
  • Do not use decongestant nasal sprays for longer than 3 days. After three days, the nasal tissues become dependent on the medication. When the medication is stopped, the nasal tissue swells and congestion worsens.

Antihistamines
Antihistamines, such as diphenhydramine (Benadryl) brompheniramine and chlorpheniramine, dry nasal tissue.

Examples include:

Precautions include:

Epstein Barr Virus Congestion in Children

Home treatment measures for congestion in children with an Epstein-Barr infection include general measures and medications. Medications include oral decongestants, decongestant nasal sprays and antihistamines.

General Measures

  • Ask your child to blow the nose gently. Forceful blowing can cause pain and bleeding.
  • Apply petroleum jelly to the nostrils if the skin becomes dry.
  • Drink plenty of liquids.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Use saline (saltwater) nose spray, such as Ocean Nasal Mist: saline helps to keep the lining of nasal passages moist.

Oral Decongestants
Oral decongestants, such as pseudoephedrine (Sudafed), help to thin the mucus responsible for the congestion. Decongestants are safe for children more than 6 years old. Talk to your doctor before providing a decongestant to a child less than 6 years old.

Decongestant Sprays
Decongestant nasal sprays, such as pseudoephedrine (Afrin), can relieve congestion faster than oral medications, but should not be used in children less than 12 years old.

Examples include:
  • Afrin Nasal Spray
  • Duration Nasal Spray
  • Four-Way Fast Nasal Spray
  • Neo-Synephrine Nasal Spray
  • Vicks Sinex Nasal Spray

Precautions include:
  • Do not use decongestant nasal sprays for longer than 3 days. After three days, the nasal tissues become dependent on the medication. When the medication is stopped, the nasal tissue swells and congestion worsens.

Antihistamines
Antihistamines, such as diphenhydramine (Benadryl) brompheniramine and chlorpheniramine, dry nasal tissue. Antihistamines are safe for children more than 5 years old. Talk to your doctor before providing an antihistamine to a child less than 5 years old.

Examples include:

Precautions include:

Diphenhydramine Dosing Chart
AgeDoseIntervalMax Daily Dose
2-5 years6.25 mg4-6 hours37.5 mg/day
6-11 years12.5-25 mg4-6 hours150 mg/day
12 and older25-50 mg4-6 hours300 mg/day

Chlorpheniramine Dosing Chart
AgeDoseIntervalMax Daily Dose
Under 6consult your physician
6-11 years2 mg4-6 hours12 mg/day
12 and up4 mg4-6 hours24 mg/day

Epstein Barr Virus Pain and Fever Adults

Medications commonly used to control pain and fever in adults with an Epstein-Barr infection include:


Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.

Aspirin

Ibuprofen

Naproxen

Ketoprofen

NSAID Precautions

Epstein Barr Virus Pain and Fever Children

Common medications used at home for pain and fever in children with an Epstein-Barr infection include:


Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.

Ibuprofen

Naproxen

Epstein Barr Virus Warning Signs

Notify your doctor if you have an Epstein-Barr infection and any of the following:

Continue to Epstein Barr Virus Underlying Cause

Last Updated: Feb 17, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Epstein Barr Virus References
  1. Comito MA, Sun Q, Lucas KG. Immunotherapy for Epstein-Barr virus-associated tumors. Leuk Lymphoma. 2004 Oct;45(10):1981-7. [15370241]
  2. Mayer HB, Wanke CA, Williams M, Crosson AW, Federman M, Hammer SM. Epstein-Barr virus-induced infectious mononucleosis complicated by acute renal failure: case report and review. Clin Infect Dis. 1996 Jun;22(6):1009-18. [878370]
  3. Sevilla J, del Carmen Escudero M, Jimenez R, Gonzalez-Vicent M, Manzanares J, Garcia-Novo D, Madero L. Severe systemic autoimmune disease associated with Epstein-Barr virus infection. J Pediatr Hematol Oncol. 2004 Dec;26(12):831-3. [15591906]
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