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Seeking Guidance: Duration of Severe Mono Symptoms

7/28/2025, 12:10:35 PMMale25-34

I’m looking for advice regarding my brother’s condition and whether he should return to the doctor. He currently does not have a primary care physician, as he is still trying to find one while on a waiting list. He’s a 22-year-old male, stands at 5’11” and weighs roughly 150 pounds. He has no chronic health issues and isn’t on any medication. He drinks alcohol occasionally but does not smoke. Three weeks ago, he began experiencing a sore throat. Nine days ago, the lymph nodes in his neck became so swollen that they distorted his facial appearance, accompanied by a rash across his neck and face. After visiting the hospital, tests confirmed he has mononucleosis (mono). He was prescribed a steroid to alleviate the swelling in his throat and was advised to take time off from his physically demanding job, which involves heavy lifting and constant movement. He was instructed to rest and stay well-hydrated, and he is scheduled to return to work on Wednesday. However, just last night, he noticed his throat swelling again. He appears to be really unwell, often drowsy and barely conscious. He wakes intermittently to take sips of water and some pain relief medication, then quickly falls back asleep. I estimate he’s lost about 10 to 15 pounds in the past month. I’m trying to persuade him to revisit the hospital due to his throat swelling and difficulties with swallowing. Although he has a mild fever, it’s not severe, and I suspect the medication may be helping to lower his temperature. Is it common for mono to present in this manner? From my research, I understand that fatigue can persist for some time, yet I thought other symptoms would have started to show signs of improvement by now. I’m genuinely worried about how ill he looks, but I’ve never dealt with someone who has mono before, so I’m uncertain about what to expect.

FibromyalgiaCrohn's DiseaseInternal Medicine

Answers (1)

Cony

7/28/2025, 12:10:53 PM

OpenHealth AI

It sounds like your brother is experiencing significant symptoms from his mononucleosis, and your concern for his well-being is valid. While some symptoms of mono can linger, the severity and recurrence of symptoms you describe, particularly his increased throat swelling and lethargy, could indicate a need for further evaluation.

Key Points:

  1. Ongoing Symptoms: It is not uncommon for mononucleosis to cause prolonged fatigue and discomfort, but severe swelling, difficulty swallowing, and significant weight loss may require closer medical attention.
  2. Weight Loss & Lethargy: Losing 10 to 15 pounds and appearing drowsy or barely conscious are concerning signs that might suggest he is not recovering as expected.

Why Revisit a Doctor:

  • Increased Throat Swelling: This can pose a risk of airway obstruction, which is serious.
  • Severe Fatigue and Drowsiness: These could indicate complications or a lack of adequate hydration and nutrition.
  • Weight Loss: Needs to be addressed, as it can affect his recovery and overall health.

Actionable Steps:

  1. Seek Medical Care: Encourage him or arrange for him to revisit the hospital or seek out urgent care. Explain that his symptoms have worsened, particularly the throat swelling and extreme fatigue. This is important for ensuring that no complications, like splenic rupture, occur.
  2. Hydration and Nutrition: In the meantime, ensure he stays hydrated as best he can, and encourage small, frequent sips of fluids. Offer high-calorie, soft foods if swallowing is manageable, to help mitigate weight loss.
  3. Monitor Symptoms: Keep a close eye on any changes in his condition. If he develops difficulty breathing or severe pain, this requires immediate attention.

Reassurance:

It's commendable that you are looking out for him. Mono can feel overwhelming, and while many recover without significant issues, it’s essential to listen to the body, especially when symptoms intensify. Prioritizing a visit to healthcare professionals will provide him with the support he needs during this time.

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