Mono Rash

What is Mono Disease?

Mononucleosis or mono is a viral infection which is accompanied by symptoms like fever, sore throat and swollen lymph glands. This viral infection is caused by human herpes virus type 4, also known as Epstein-Barr virus and several other organisms like cytomegalovirus. This virus is transferred from one person to the other through saliva, kissing and sharing glasses. The incubation period for this infection varies from 1 to 1.5 months.

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Also known as “the kissing disease”, Mononucleosis can occur in any age but is most common in age group of 14 to 24.


Mono starts with fatigue, feeling of being sick, severe headache and sore throat which gradually becomes worse. Tonsils which were developed in the early phase of the infection get swollen and whitish-yellow covering is formed. Also lymph nodes in the neck are swollen and cause pain. The most common symptoms of mono rash are:

  • Fever
  • Drowsiness
  • Loss of appetite
  • Uneasiness and discomfort
  • Muscle ache and stiffness
  • Sore throat
  • Rash
  • Swollen lymph nodes
  • Swollen spleen

Some less common symptoms are listed below:

  • Chest pain
  • Fatigue
  • Headache
  • Cough
  • Hives
  • Nose stiffness and nose bleed
  • Hives
  • Rapid heart rate
  • Shortness of breath
  • Sensitivity to light

The fever lasts for at least 8 to 12 days while it takes more than 3 weeks for swollen lymph glands and spleen to heal. In few cases fatigue goes off within a week while it may linger on for months in other cases.

How does mono rash develop?

Around 15% of the total cases of mononucleosis develop skin symptoms. Usually these are light, widespread rash which lasts for over a week or so. Known as maculopapular exanthem, these rashes are basically flat patches having small red spots. Rash develop first on the trunk and upper arms which soon spread on the face and forearms. Rash may also look like:

  • Popular – small bumps
  • Purpuric – bruise-like appearance
  • Morbilliform –  small, measles-like patches
  • Vesicular- little blisters
  • Scarlatiniform – tiny spots

People with mononucleosis usually develop more intense rash than various forms mentioned above. Maculopapular or morbilliform rash develop on extensor surfaces when mononucleosis patient is treated with antibiotics like ampicillin, amoxicillin and cephalosporin. If such rashes appear then it is a clear indication of hypersensitivity reaction to antibiotic. But this is not a real allergy and does not mean that the person is allergic to such medications.

Sometimes the person suffering from the sore throat mononucleosis also gets streptococcal infection. It is also possible that person develops tonsil infections and sinus infection. This viral infection is also associated with tiredness right from the beginning till the symptoms disappear.

Mononucleosis can also affect other organs of the body. This includes enlarged spleen i.e. Splenomegaly, arthritis in joints, Hepatitis, glomerulonephritis, interstitial pneumonia and pericarditis. Sometimes nervous system is also affected by mono infection and causes bell’s palsy, transverse myelitis, meningoencephalitis and Guillain-Barre syndrome. Symptoms in eyes including swollen eyelids, uveitis, retinitis, conjunctivitis and keraitis. In rare case mononucleosis also affect blood system and produces symptoms such as autoimmune haemolytic anaemia, neutropaenia, immunodeficiency, cold agglutinins and thrombocytopenia.

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Mono or mononucleosis is mostly diagnosed with the blood test to detect the atypical lymphocytes. The doctor may also ask for monospot screening test because many viral infections other than mononucleosis can cause symptoms which will also give positive atypical lymphocytes.

Also, liver function test is conducted in certain cases. Some more tests would be required depending on which organ is affected by this viral infection. Antibody titer which determines the difference between present and previous infection is also recommended.


There’s no treatment available for mononucleosis and antibiotics do not work in most types of viral infections including mono viral infection. It is recommended to take bed rest and drink lots of fluid to fight against this infection. To ease sore throat, gargles with salt water prove to be very effective. To relive pain and fever acetaminophen and ibuprofen can be taken.

Simple analgesia like paracetamol will also help to treat mono viral infection. Sometimes doctor will also prescribe acicoliver but this medication is not much effective. Person who also has swollen spleen should stay away from sports till the swelling goes away.

In order to treat secondary infections which accompany mononucleosis, certain antibiotics are used. In mono infection there’s a likelihood of people getting rashes particularly with amoxicillin and some other penicillin derivatives. Therefore these medications should not be prescribed to people with mononucleosis. In fact one drug of this kind is sufficient to cause rash. However there are other antibiotics used to treat these secondary infections.

To relieve tonsil and swelling of the throat, doctors usually prescribe corticosteroid medications like prednisone.

The person is fully recovered once the symptoms go away but it takes several weeks or even months for symptoms to disappear.

Mono Rash Pictures

Here are pictures of mono rash, check out how it appears on the skin.

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  1. Hi, i am a traveller currentky in the us. My daughter fell sick and we went to er on monday and she was prescribed with amoxcilion. The swab test was negative for strap but positive on the culture. It has been about 3 days since we take the medication (first taken monday midnight) and rash start to show on friday morning. Is it mono or allergy? The rashes are small slightly raised bumps and they are itchy. What should i do? Stop the amoxcilin and switch to prelone? Or just go with it but take benadryl? Appreciate your peompt response as it is very hard for me to get medical help here, being a travelwr with no american medical insurance

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