Mono? Pneumonia? Something else?


My roommate infected me with some kind of virus that he had (actually still has it) and I got over it in one day. He, on the other hand, went out with his friends, drank insanely, stayed out all night, and consequently got sicker and sicker. Now, he's left for a few days to recover at home. I was wondering, since he got so sick (he was ill for over eight days, was coughing, vomiting, etc.), is it possible that he may have contracted mono, or even pneumonia? And if it is, should I be concerned for myself?


Dear Curious,

Although there's no way to diagnose your friend's illness online, his symptoms don’t appear to match the most common signs and symptoms of mono or pneumonia. Still, it sounds as though he would benefit from an appointment with a health care provider to properly diagnose and treat whatever illness he may have. As for whether to be concerned about yourself, it can be hard to say given that it's unclear what your friend is experiencing. That being said, if you're unsure or concerned, you can always reach out to a health care provider to be sure. 

Since you asked, here’s a quick review of both infections:

Mononucleosis (or mono) is caused by the Epstein-Barr virus (EBV). It’s most common among teenagers and young adults, especially college students who likely live in close proximity to one another. Although it used to be called the "kissing disease," mono is spread by any close contact with an infected individual (usually with their saliva). This means you could be exposed through a cough, a sneeze, or even by sharing the same utensils with an infected person. While it sounds easy to contract, mono is much less contagious than the common cold and symptoms usually don’t appear until four to six weeks after contact.

Symptoms of mono include severe sore throat with a painful swelling of lymph nodes in the neck, lethargy, a fever, and, occasionally, a rash. It’s also possible for the spleen (found on the left side in your abdomen) to become enlarged, which may cause harm. Because mono is caused by a virus, antibiotics aren’t used, as antibiotics are intended to cure bacterial infections. Generally, the treatment plan for mono involves plenty of sleep and fluids. As a result, those who are infected may feel fatigue for weeks, or even for several months. That being said, mono doesn’t necessarily deserve its reputation as a prolonged illness. Most people get better quickly, often within two to four weeks, and some are mild cases that hardly set them back at all.

Pneumonia, on the other hand, can be caused by a viral, bacterial, or even a fungal infection of the air sacs in the lungs. Symptoms usually include fever, shortness of breath, a persistent cough (that may have phlegm), and chest pain (often when breathing). The specific treatment depends on the type and severity of pneumonia infection. For instance, bacterial pneumonia may require an antibiotic for treatment once the causative bacteria is identified. It’s also worth noting that pneumonia may be more common in individuals with EBV due to their weakened immune system.

Though it’s not clear whether you and your roommate had the same infection, you’re quite perceptive in noticing the dramatic difference between the course of your illness compared to your roommate’s. Furthermore, an individual’s immune response can be influenced by their overall health and behaviors. Research has shown that immune function rises and falls inversely with stress — stress decreases the body’s white blood cells that help fight off infection. Stress may range from emotional stressors, such as anger, anxiety, depression, and grief, to physical stressors, such as poor nutrition, sleep deprivation, overexertion, smoking, and drinking. Your experience, combined with research, shows that when someone starts to feel a bit sick it’s a good idea to take it easy from the beginning. Pushing through may risk a recurring, prolonged, or worse illness. In your roommate’s case, it might be a good idea for them to talk with a health care provider who will be able to test for different types of infections.

All that said, your best bet is to try to maintain your health by managing your stress, eating nutritious foods, and washing your hands frequently, to name a few key strategies.

Last updated Feb 14, 2020
Originally published Oct 06, 1994

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