Stephen J. Schueler, M.D.

Mononucleosis Home Care

Home care for mononucleosis includes:

Mononucleosis Pain and Fever Adults

Medications commonly used to control pain and fever in adults with mononucleosis 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

Mononucleosis Pain and Fever Children

Common medications used for pain and fever in children with mononucleosis 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

Mononucleosis Sore Throat in Adults

Home care for a sore throat in an adult with mononucleosis includes:

  • Avoid alcohol.
  • Avoid citrus juice.
  • Avoid hot and spicy foods.
  • Do not smoke and avoid exposure to secondary smoke.
  • Drink plenty of fluids.
  • Get plenty of rest.
  • Numb the throat pain with throat spray or lozenges.
  • Gargle with warm salt water several times a day. Mix 1/2 teaspoon (92.5 ml) salt per cup (240 cc) of water.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Take acetaminophen or ibuprofen for pain.

Mononucleosis Sore Throat in Children

Home care for a sore throat in a child with mononucleosis includes:

  • Avoid citrus juice.
  • Avoid hot and spicy foods.
  • Avoid exposure to secondary smoke.
  • Drink plenty of fluids.
  • Get plenty of rest.
  • Numb the throat pain with throat spray or lozenges.
  • Gargle with warm salt water several times a day. Mix 1/2 teaspoon (92.5 ml) salt per cup (240 cc) of water.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Take acetaminophen or ibuprofen for pain.

Mononucleosis Vomiting in Adults

Home care for vomiting in an adult with mononucleosis includes:

  • Drink clear liquids only, such as water, sports drinks, fruit juice and dilute tea.
  • Drink small quantities of fluids frequently. In general, two tablespoons of fluid every 5 minutes is an effective strategy.
  • Avoid milk and dairy products for 3 days.
  • Avoid liquids that irritate the stomach, such as citrus juice, alcohol and coffee.
  • If nausea or vomiting continues despite the above, consider one of the nonprescription medicines listed below.
  • Once vomiting and nausea resolves, start bland foods first. If you tolerate bland food, then you can resume a normal diet.

Nonprescription medications for vomiting include:

Mononucleosis Vomiting in Children

Home treatment of vomiting in children with mononucleosis includes hydration and dietary therapy. Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in infants include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte

ORT fluids used in older children include:
  • Sports drinks (Gatorade)
  • Broth
  • Dilute fruit juices
  • Flat soda
  • Weak tea with sugar

Strategies for breast-fed infants younger than 6 months:
  • If the infant tolerates breast milk, continue breast-feeding in small amounts very frequently.
  • Provide additional ORT fluids to supplement breast milk.
  • Feed very small amounts every 30-60 minutes, or try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for formula-fed infants younger than 6 months:
  • If the infant tolerates formula, continue to provide small amounts very frequently.
  • Provide additional ORT fluids to formula.
  • Try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for children over 6 months:
  • Provide as much ORT fluids as your child desires.
  • If vomiting occurs, provide small amounts of ORT fluids more frequently:
    • Children 10-20 kg (22-44 lb): 15 ml (1 tablespoon) every 5 minutes
    • Children 20-40 kg (44-88 lb): 22 ml (1 and 1/2 tablespoons) every 5 minutes
    • Children 40 kg (88 lb) and over: 30 ml (2 tablespoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Dietary Therapy
Most children with vomiting improve in a few hours and symptoms usually resolve in one day. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that are easiest to tolerate include:
  • Crackers
  • Oatmeal
  • Jell-O
  • Soft foods
  • Yogurt

Foods to avoid include:
  • Concentrated fruit juices
  • Junk foods
  • Milk products
  • Recently introduced foods
  • Spicy foods

Nonprescription medicines for vomiting should only be used under the direction of your doctor.

Mononucleosis Warning Signs

Notify your doctor if you have mononucleosis and you develop any of the following:

Continue to Mononucleosis Prevention

Last Updated: Mar 14, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Mononucleosis References
  1. Auwaerter PG. Infectious mononucleosis: return to play. Clin Sports Med. 2004 Jul;23(3):485-97, xi. [15262384]
  2. Ebell MH. Epstein-Barr virus infectious mononucleosis. Am Fam Physician. 2004 Oct 1;70(7):1279-87. [15508538]
  3. Grotto I, Mimouni D, Huerta M, Mimouni M, Cohen D, Robin G, Pitlik S, Green MS. Clinical and laboratory presentation of EBV positive infectious mononucleosis in young adults. Epidemiol Infect. 2003 Aug;131(1):683-9. [12948368]
  4. Hanna BC, McMullan R, Hall SJ. Corticosteroids and peritonsillar abscess formation in infectious mononucleosis. J Laryngol Otol. 2004 Jun;118(6):459-61. [15285866]
  5. Kinderknecht JJ. Infectious mononucleosis and the spleen. Curr Sports Med Rep. 2002 Apr;1(2):116-20. [12831720]
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