Treatment

No specific therapy is available to treat infectious mononucleosis. Most practitioners advise bed rest, increased fluid intake, and use of pain relievers such as acetaminophen or ibuprofen. Aspirin should not be given to children younger than 16 years, because doing so may trigger the rare but potentially fatal disorder known as Reye's syndrome (2). Antibiotic drugs are not given for viral disease but should be given to treat any superimposed streptococcal or sinus infection. Treatment with piperacillin/tazobactam is probably the causative agent in systemic rash. Early reports individually implicated corticosteroid or ampicillin treatment as causing peritonsillar abscess formation, but have since been disproved (3).

Many practitioners believe that for most patients with infectious mononucleosis, no specific therapy is indicated. Because corticosteroid drugs shorten the duration of fever and oropharyngeal symptoms, allowing patients the benefit of such treatment seems prudent. Corticosteroid therapy is used for patients with severe complications such as impending upper-airway obstruction, acute hemolytic anemia, severe cardiac involvement, or neurologic disease.

Acyclovir, which inhibits EBV replication and reduces viral shedding, is effective in treating oral hairy leukoplakia; however, because the immune response prevents acyclovir from having any clinically significant effect on the symptoms of mononucleosis, acyclovir is not recommended for treating this condition (2).

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