I brought my 3 1/2 year old to the doctor today, a little concerned that I was being overly cautious. I was pretty surprised at the diagnosis, however, and very glad I brought her in!
Symptoms
Since Thursday, Isabelle's voice has sounded muffled, as if she had a sore throat. She's usually great about telling me when she doesn't feel well, but this time, she has insisted that she feels great.
She has had very little fatigue, although she did take naps for several days last week. Prior to that, we've been having more of a "rest time," since she seemed to have outgrown a real nap.
I've assumed her sore throat was due to allergies or a cold, and in fact she did cough occasionally. On Saturday, with her curly brown hair pulled back into a ponytail, I noticed that one of her lymph nodes seemed really large. I was concerned, but my husband pointed out how energetic and playful she'd been. After taking a nap on Saturday, she had a great time playing in the backyard and splashing around in the blow-up baby pool.
Finally, on Sunday evening, she started running a fever of around 100. My first thought was strep throat, since a friend of hers had it a week before and had been at our house last week, although she was beyond the point of being contagious. Instead of waiting it out, we decided to go to the doctor on Monday morning because if it was strep, I knew she would need antibiotics.
The Diagnosis
Our pediatrician felt her lymph nodes and then felt her abdomen, even marking her tummy with a pen and then measuring the size of her spleen with a tape measure. He said her lymph node pattern and enlarged spleen were indicative of a text book case of mono! Not what I was expecting at all!
He did a strep test, "just in case," since it's one of the few things you can test for, but that came back negative. He also did a blood test for the Epstein-Barr virus, which causes mono. We'll have the results tomorrow or Wednesday, but even if the mono test is negative, his diagnosis is still that she has an unnamed mono-like illness. The tests came back positive for mono, just as he'd suspected.
No Big Deal!
And the doctor says this is no big deal. Now that I know more about it, I agree that it's no big deal. Evidently, mono affects little kids very differently than it affects teens and adults.
In a young child, the fatigue is very minor, if present at all. Isabelle has taken naps, but otherwise, she hasn't seemed tired at all. She's been playing outside and even running around inside having a grand time. She wakes up full of energy at 6:45 every morning, ready to play. And the doctor said that she's probably already over the worst of it.
There's no need to limit her activity. She can play outside in the heat, go swimming, and do everything she normally does. She shouldn't wrestle or participate in any other activity with high physical contact because of the risk of rupturing her spleen, but those aren't things she normally does anyway. She's a very active little girl, but let's face it: she plays like a girl! Everything is about dress-up, doll houses, and dancing. We did, however, elect not to allow her to go to a birthday party at a local bounce house. Mono is not a big deal, but a ruptured spleen would have been a major problem and it wasn't worth the risk.
We do have a follow-up appointment in 2 weeks to make sure that her spleen is no longer enlarged, but otherwise, there's just not much to be concerned about.
Isolation?
My next question was about isolation, but the doctor said she's fine to go about her usual activities. I specifically asked about being in our church's nursery, but he said that as long as no one drinks after her, they won't be getting mono. It's only contagious through saliva. Our pediatrician said that they do not isolate children or keep them from going to daycare when they have mono.
Here's a link from the Children's Physician Network about mono that confirms the information I received from our doctor.
Taken two days ago: My poor sick little girl. Ha! Hardly!
The bottom line is that from a parenting standpoint, mono isn't too bad of a diagnosis in this case. A cold, virus, or strep would've required quite a bit more work from me as a mom. With mono, there's absolutely nothing to do, and her behavior seems fine. Her fever is even gone today, so I'm not giving her ibuprofen or anything else.
Have any of you had young children with mono? How long did it seem to last? Were their symptoms mild as well?
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