Red flags & when to go in person for Mononucleosis (Suspected) - Triage

Audience: adult

Mononucleosis, often called "mono" or the "kissing disease," is a viral infection commonly caused by the Epstein-Barr virus. It typically causes symptoms like fever, sore throat, swollen lymph nodes, and extreme tiredness. Most people recover with rest and supportive care. However, some symptoms may signal serious complications that need prompt in-person medical attention. This guide helps you understand when telemedicine can support your care and when you should seek in-person evaluation. Recognizing red flags such as severe throat swelling, difficulty breathing or swallowing, intense abdominal pain, or signs of dehydration is crucial. Telemedicine can help with initial advice, symptom monitoring, and guidance on self-care, but it cannot replace physical exams or urgent treatments when complications arise. Always prioritize your safety by seeking in-person care if you experience any warning signs or worsening symptoms.

Red flags — go in person / ER

• Difficulty breathing or swallowing — seek emergency care immediately.
• Severe abdominal pain or swelling, especially in the upper left side — possible spleen enlargement or rupture.
• High fever unresponsive to medication lasting more than 3 days.

What telemedicine can do

• Initial symptom assessment and history taking.
• Providing advice on symptom management and self-care.
• Monitoring symptoms and deciding if in-person care is needed.
• Answering questions about the illness and expected course.

What telemedicine cannot do

• Physical examination including throat and abdominal palpation.
• Emergency interventions for airway obstruction or severe complications.
• Diagnostic testing such as blood tests or imaging.
• Treatment of severe dehydration or complications requiring hospitalization.

What is Mononucleosis?

Mononucleosis is an infection usually caused by the Epstein-Barr virus. It spreads through saliva, which is why it’s sometimes called the "kissing disease." Common symptoms include fever, sore throat, swollen lymph nodes, and feeling very tired. Most people get better with rest and fluids over a few weeks.

Common Symptoms to Watch For

Typical signs of mono include:

These symptoms often improve with rest, but you should monitor how you feel closely.

When to Seek In-Person Care: Red Flags

Some symptoms may indicate serious problems needing urgent medical attention:

If you notice any of these signs, go to an emergency room or urgent care immediately.

How Telemedicine Can Help

Telemedicine visits can help you by:

However, telemedicine cannot perform physical exams or urgent interventions.

Preparing for Your Telemedicine Visit

Before your tele-visit:

This preparation helps your healthcare provider give the best advice.

After Your Telemedicine Visit

After your appointment:

Keep a record of your symptoms and any changes to share with your provider.

How to prepare for your tele-visit

• List your symptoms with start dates and severity.
• Prepare to describe any difficulty breathing, swallowing, or severe pain.
• Have a list of current medications and allergies ready.
• Ensure a quiet and private space with reliable internet for the tele-visit.
• Have a thermometer and any recent vital signs available if possible.

After your tele-visit

• Follow the self-care advice provided, including rest and hydration.
• Monitor your symptoms daily and note any changes.
• Seek in-person care if red flags or worsening symptoms occur.
• Take medications as directed by your healthcare provider.
• Schedule follow-up appointments as recommended.

FAQs

Can mononucleosis be treated with antibiotics?

Mononucleosis is caused by a virus, so antibiotics do not work against it. Antibiotics may be prescribed only if there is a bacterial infection alongside mono, but they do not treat the viral infection itself.

How long does it usually take to recover from mono?

Most people recover from mononucleosis within 2 to 4 weeks, but fatigue can last longer. Rest and avoiding strenuous activities, especially contact sports, are important during recovery.

Is mononucleosis contagious?

Yes, mononucleosis spreads mainly through saliva, so close contact like kissing or sharing utensils can transmit the virus. It can also spread through coughs or sneezes.

When should I go to the hospital if I have mono?

Seek emergency care if you have trouble breathing or swallowing, severe throat swelling, intense abdominal pain, high fever not responding to medication, or signs of dehydration. These may indicate serious complications.

Can I return to work or school if I have mono?

You should rest until your fever is gone and you feel well enough. Because fatigue can last weeks, it’s important to avoid overexertion. Follow your healthcare provider’s advice about returning to normal activities.

Sources

1. Mononucleosis — MedlinePlus, U.S. National Library of Medicine.
2. Infectious Mononucleosis — Centers for Disease Control and Prevention (CDC).
3. Mononucleosis (Mono) — Mayo Clinic.
4. Mononucleosis — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical evaluation and care. If you experience any serious or worsening symptoms, seek immediate medical attention.