Table of ContentsView AllTable of ContentsSymptomsClassic RashVariationsOther CausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Classic Rash
Variations
Other Causes
Diagnosis
Treatment
Different people may experience different manifestations of a mono rash, includinghivesorpetechiae(purplish blood spots).
Whatever the appearance, a mono rash may be suspected if it occurs with other mono symptoms, includingswollen lymph nodes, sore throat, body aches, and persistent, draining fatigue. The diagnosis may be confirmed with an antibody blood test.
A rash can also sometimes occur in response toantibioticsused to treat complications of mono, particularlyAmoxil (amoxicillin).
Hello World / Getty Images
What Is Infectious Mononucleosis?
Epstein-Barr virus (EBV) is an extremely common virus affecting around 95% of adults, most of whom experienced no symptoms.
Younger children, in particular, tend to have few, if any, mono symptoms. However, in teens and young adults, mono can cause a plethora of longer-lasting symptoms like:
Symptoms of mono typically for two to four weeks and usually resolve without treatment. While potentially debilitating, mono is rarely life-threatening.
How Common Is a Mono Rash?A skin rash is a less common manifestation of infectious mononucleosis. Studies suggest that between 4.2% and 13% of people who get mono will develop a rash.
How Common Is a Mono Rash?
A skin rash is a less common manifestation of infectious mononucleosis. Studies suggest that between 4.2% and 13% of people who get mono will develop a rash.
Natalya Maisheva / Getty Images
What a Mono Rash Looks Like
Classically, a mono rash is described as beingmaculopapular. A maculopapular rash is a mix of macules (flat discolored areas of skin) and papules (small raised bumps) that usually cover a large area of skin.The rash may appear red or pink if your skin is light, or darker if your skin is dark.
Infections that cause a maculopapular rash includerubellaandscarlet fever. It is also common with drug rashes.
Most cases resolve on their own within a week.
Other Variations of the Mono Rash
A maculopapular rash is the most common presentation of the mono rash, but it is not the only one. When you get EBV, the virus can trigger animmune responsethat can lead to different types of rash, either independent of the classic rash or occurring with it.
WikiCommons.
Urticaria (Hives)
Urticaria, also known as hives, can sometimes occur with mono. Hives are raised welts that are typically itchy and can either be the same color as the skin or slightly red.
Hivescan occur when the immune system reacts to the presence of EBV, triggering the release ofhistamineand other chemicals that cause skin inflammation and the leakage of fluids into the middle layer of skin, called thedermis.
Hives can affect any part of the body but are less common on the face.
Wiki Commons.
Petechiae
Petechiaeare small red or purple spots about the size of a pinpoint. They develop when tinycapillariesbeneath the skin burst, causing tiny pools of blood that look like spots.
Petechiae can occur with many infectious diseases, includingCOVID-19and infectious mononucleosis. Infections like these can cause abrupt, systematic (whole-body) inflammation that causes capillaries to weaken and burst, typically in large clusters.
Petechiae can occur on any part of the body but is commonly seen on the forearms, calves, torso, and chest. With mononucleosis, petechiae is frequently seen in the lips and the roof of the mouth, and sometimes on the genitals.
Petechiae are usually flat. When you press on them, they will not blanch (whiten). Besides the characteristic spots, petechiae does not cause any other skin symptoms.
Wiki Commons
Other Causes of Rash
If you have infectious mononucleosis, therashyou may experience may not be due to EBV but rather toantibioticssometimes used to treat complications of mono.
As a viral infection, EBV does not respond to antibiotic drugs used to treat bacterial infections. If used, antibiotics can cause a hypersensitivity reaction that leads to a spontaneous and generalized outbreak of rash.
With mono, the acute stage of infection (when the virus is aggressively replication) can cause transient drug hypersensitivity. The reaction is strongest with the antibiotic Amoxil (amoxicillin) but can occur with anybeta-lactam antibiotic, includingpenicillinsandcephalosporins.
When antibiotics are used with mono, a rash will develop in 27% to 69% of cases. In children with mono, antibiotics almost always cause a rash.
Symptoms of an antibiotic rash include:
When to Call 911In rare cases, this use of antibiotics with EBV can lead to a potentially life-threatening, whole-body allergy known asanaphylaxis. Left untreated, anaphylaxis can lead to shock, coma, and death.Call 911 if you developsigns and symptoms of anaphylaxis, including:Severe rash or hivesWheezingSwelling of the face, mouth, or throatIrregular heartbeatShallow, rapid breathingLightheadedness or dizzinessNausea or vomitingA feeling of impending doom
When to Call 911
In rare cases, this use of antibiotics with EBV can lead to a potentially life-threatening, whole-body allergy known asanaphylaxis. Left untreated, anaphylaxis can lead to shock, coma, and death.Call 911 if you developsigns and symptoms of anaphylaxis, including:Severe rash or hivesWheezingSwelling of the face, mouth, or throatIrregular heartbeatShallow, rapid breathingLightheadedness or dizzinessNausea or vomitingA feeling of impending doom
In rare cases, this use of antibiotics with EBV can lead to a potentially life-threatening, whole-body allergy known asanaphylaxis. Left untreated, anaphylaxis can lead to shock, coma, and death.
Call 911 if you developsigns and symptoms of anaphylaxis, including:
Diagnosing a Mono Rash
To diagnose mono, a healthcare provider will review your medical history and perform a physical exam, checking your throat, lymph nodes, and belly. If mono is suspected, your provider will order blood tests to confirm the diagnosis, including:
How Mono Rashes Are Treated
There is no cure or specifictreatment for mono.
Typically, people with mono will get better with plenty of rest, fluids, and over-the-counter (OTC)pain relieversorsore throat lozenges. The mono rash will usually clear on its own within a week, though symptoms like fatigue may persist for weeks.
How Mononucleosis Is Treated
Summary
Less commonly, EBV can trigger an immune response that leads to hives or tiny blood spots called petechiae. Antibiotics sometimes used to treat mono can also cause a hypersensitive rash.
How Long Does Mono Fatigue Last?
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Theocharis Koufakis, Ioannis Gabranis.Infectious mononucleosis skin rash without previous antibiotic use.Brazil J Infect Dis.2015 Sep-Oct;19(5):553. doi:10.1016/j.bjid.2015.04.005Chin YY, Chang TC, Chang CH.Idiopathic pure sudomotor failure and cholinergic urticaria in a patient after acute infectious mononucleosis infection.Clin Exp Dermatol. 2013;38(2):156-159. doi:10.1111/j.1365-2230.2012.04437.xNakagawa H, Miyata Y, Maekawa M.Infectious mononucleosis with eyelid edema and palatal petechiae.Korean J Intern Med..2021 Jul;36(4):1027–1028. doi:10.3904/kjim.2020.350Ónodi-Nagy K, Kinyó Á, Meszes A, Garaczi E, Kemény L, Bata-Csörgő Z.Amoxicillin rash in patients with infectious mononucleosis: evidence of true drug sensitization.Allergy Asthma Clin Immunol.2015;11(1):1. doi:10.1186/1710-1492-11-1Akiyama Y, Ishikane M, Ohmagari N.Epstein-Barr virus induced skin rash in infectious mononucleosis.IDCases. 2021;26:e01298. Published 2021 Sep 29. doi:10.1016/j.idcr.2021.e01298Koufakis T, Gabranis Il.Infectious mononucleosis skin rash without previous antibiotic use.Braz J Infect Dis. 2015 Sep-Oct;19(5):553. doi:10.1016/j.bjid.2015.04.005Lee J, Ramam M.Drug-induced vs. viral maculopapular exanthem—resolving the dilemma.Dermatopathology (Basel). 2022;9(2):164-171. doi:10.3390/dermatopathology9020021American Academy of Dermatology Association.Hives.Kayiran MA, Akdeniz N.Diagnosis and treatment of urticaria in primary care.North Clin Istanb.2019;6(1):93-99. doi:10.14744/nci.2018.75010Thomas AE, Baird SF, Anderson J.Purpuric and petechial rashes in adults and children: initial assessment.BMJ. 2016;352:i1285. doi:10.1136/bmj.i1285Womack J, Jimenez M.Common questions about infectious mononucleosis.Am Fam Physician.2015;91(6):372-376.American Academy of Allergy, Asthma & Immunology.Penicillin allergy FAQ.LoVerde D, Iweala OI, Eginli A, Krishnaswamy G.Anaphylaxis.Chest. 2018;153(2):528-543. doi:10.1016/j.chest.2017.07.033HealthLink BC.Mononucleosis tests.Centers for Disease Control and Prevention.About infectious mononucleosis.Kenzaka T, Ueda Y.Skin rash in a patient with infectious mononucleosis.BMJ Case Rep.2013 Jul 25;2013:bcr2013010236. doi:10.1136/bcr-2013-010236
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Theocharis Koufakis, Ioannis Gabranis.Infectious mononucleosis skin rash without previous antibiotic use.Brazil J Infect Dis.2015 Sep-Oct;19(5):553. doi:10.1016/j.bjid.2015.04.005Chin YY, Chang TC, Chang CH.Idiopathic pure sudomotor failure and cholinergic urticaria in a patient after acute infectious mononucleosis infection.Clin Exp Dermatol. 2013;38(2):156-159. doi:10.1111/j.1365-2230.2012.04437.xNakagawa H, Miyata Y, Maekawa M.Infectious mononucleosis with eyelid edema and palatal petechiae.Korean J Intern Med..2021 Jul;36(4):1027–1028. doi:10.3904/kjim.2020.350Ónodi-Nagy K, Kinyó Á, Meszes A, Garaczi E, Kemény L, Bata-Csörgő Z.Amoxicillin rash in patients with infectious mononucleosis: evidence of true drug sensitization.Allergy Asthma Clin Immunol.2015;11(1):1. doi:10.1186/1710-1492-11-1Akiyama Y, Ishikane M, Ohmagari N.Epstein-Barr virus induced skin rash in infectious mononucleosis.IDCases. 2021;26:e01298. Published 2021 Sep 29. doi:10.1016/j.idcr.2021.e01298Koufakis T, Gabranis Il.Infectious mononucleosis skin rash without previous antibiotic use.Braz J Infect Dis. 2015 Sep-Oct;19(5):553. doi:10.1016/j.bjid.2015.04.005Lee J, Ramam M.Drug-induced vs. viral maculopapular exanthem—resolving the dilemma.Dermatopathology (Basel). 2022;9(2):164-171. doi:10.3390/dermatopathology9020021American Academy of Dermatology Association.Hives.Kayiran MA, Akdeniz N.Diagnosis and treatment of urticaria in primary care.North Clin Istanb.2019;6(1):93-99. doi:10.14744/nci.2018.75010Thomas AE, Baird SF, Anderson J.Purpuric and petechial rashes in adults and children: initial assessment.BMJ. 2016;352:i1285. doi:10.1136/bmj.i1285Womack J, Jimenez M.Common questions about infectious mononucleosis.Am Fam Physician.2015;91(6):372-376.American Academy of Allergy, Asthma & Immunology.Penicillin allergy FAQ.LoVerde D, Iweala OI, Eginli A, Krishnaswamy G.Anaphylaxis.Chest. 2018;153(2):528-543. doi:10.1016/j.chest.2017.07.033HealthLink BC.Mononucleosis tests.Centers for Disease Control and Prevention.About infectious mononucleosis.Kenzaka T, Ueda Y.Skin rash in a patient with infectious mononucleosis.BMJ Case Rep.2013 Jul 25;2013:bcr2013010236. doi:10.1136/bcr-2013-010236
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Theocharis Koufakis, Ioannis Gabranis.Infectious mononucleosis skin rash without previous antibiotic use.Brazil J Infect Dis.2015 Sep-Oct;19(5):553. doi:10.1016/j.bjid.2015.04.005Chin YY, Chang TC, Chang CH.Idiopathic pure sudomotor failure and cholinergic urticaria in a patient after acute infectious mononucleosis infection.Clin Exp Dermatol. 2013;38(2):156-159. doi:10.1111/j.1365-2230.2012.04437.xNakagawa H, Miyata Y, Maekawa M.Infectious mononucleosis with eyelid edema and palatal petechiae.Korean J Intern Med..2021 Jul;36(4):1027–1028. doi:10.3904/kjim.2020.350Ónodi-Nagy K, Kinyó Á, Meszes A, Garaczi E, Kemény L, Bata-Csörgő Z.Amoxicillin rash in patients with infectious mononucleosis: evidence of true drug sensitization.Allergy Asthma Clin Immunol.2015;11(1):1. doi:10.1186/1710-1492-11-1Akiyama Y, Ishikane M, Ohmagari N.Epstein-Barr virus induced skin rash in infectious mononucleosis.IDCases. 2021;26:e01298. Published 2021 Sep 29. doi:10.1016/j.idcr.2021.e01298Koufakis T, Gabranis Il.Infectious mononucleosis skin rash without previous antibiotic use.Braz J Infect Dis. 2015 Sep-Oct;19(5):553. doi:10.1016/j.bjid.2015.04.005Lee J, Ramam M.Drug-induced vs. viral maculopapular exanthem—resolving the dilemma.Dermatopathology (Basel). 2022;9(2):164-171. doi:10.3390/dermatopathology9020021American Academy of Dermatology Association.Hives.Kayiran MA, Akdeniz N.Diagnosis and treatment of urticaria in primary care.North Clin Istanb.2019;6(1):93-99. doi:10.14744/nci.2018.75010Thomas AE, Baird SF, Anderson J.Purpuric and petechial rashes in adults and children: initial assessment.BMJ. 2016;352:i1285. doi:10.1136/bmj.i1285Womack J, Jimenez M.Common questions about infectious mononucleosis.Am Fam Physician.2015;91(6):372-376.American Academy of Allergy, Asthma & Immunology.Penicillin allergy FAQ.LoVerde D, Iweala OI, Eginli A, Krishnaswamy G.Anaphylaxis.Chest. 2018;153(2):528-543. doi:10.1016/j.chest.2017.07.033HealthLink BC.Mononucleosis tests.Centers for Disease Control and Prevention.About infectious mononucleosis.Kenzaka T, Ueda Y.Skin rash in a patient with infectious mononucleosis.BMJ Case Rep.2013 Jul 25;2013:bcr2013010236. doi:10.1136/bcr-2013-010236
Theocharis Koufakis, Ioannis Gabranis.Infectious mononucleosis skin rash without previous antibiotic use.Brazil J Infect Dis.2015 Sep-Oct;19(5):553. doi:10.1016/j.bjid.2015.04.005
Chin YY, Chang TC, Chang CH.Idiopathic pure sudomotor failure and cholinergic urticaria in a patient after acute infectious mononucleosis infection.Clin Exp Dermatol. 2013;38(2):156-159. doi:10.1111/j.1365-2230.2012.04437.x
Nakagawa H, Miyata Y, Maekawa M.Infectious mononucleosis with eyelid edema and palatal petechiae.Korean J Intern Med..2021 Jul;36(4):1027–1028. doi:10.3904/kjim.2020.350
Ónodi-Nagy K, Kinyó Á, Meszes A, Garaczi E, Kemény L, Bata-Csörgő Z.Amoxicillin rash in patients with infectious mononucleosis: evidence of true drug sensitization.Allergy Asthma Clin Immunol.2015;11(1):1. doi:10.1186/1710-1492-11-1
Akiyama Y, Ishikane M, Ohmagari N.Epstein-Barr virus induced skin rash in infectious mononucleosis.IDCases. 2021;26:e01298. Published 2021 Sep 29. doi:10.1016/j.idcr.2021.e01298
Koufakis T, Gabranis Il.Infectious mononucleosis skin rash without previous antibiotic use.Braz J Infect Dis. 2015 Sep-Oct;19(5):553. doi:10.1016/j.bjid.2015.04.005
Lee J, Ramam M.Drug-induced vs. viral maculopapular exanthem—resolving the dilemma.Dermatopathology (Basel). 2022;9(2):164-171. doi:10.3390/dermatopathology9020021
American Academy of Dermatology Association.Hives.
Kayiran MA, Akdeniz N.Diagnosis and treatment of urticaria in primary care.North Clin Istanb.2019;6(1):93-99. doi:10.14744/nci.2018.75010
Thomas AE, Baird SF, Anderson J.Purpuric and petechial rashes in adults and children: initial assessment.BMJ. 2016;352:i1285. doi:10.1136/bmj.i1285
Womack J, Jimenez M.Common questions about infectious mononucleosis.Am Fam Physician.2015;91(6):372-376.
American Academy of Allergy, Asthma & Immunology.Penicillin allergy FAQ.
LoVerde D, Iweala OI, Eginli A, Krishnaswamy G.Anaphylaxis.Chest. 2018;153(2):528-543. doi:10.1016/j.chest.2017.07.033
HealthLink BC.Mononucleosis tests.
Centers for Disease Control and Prevention.About infectious mononucleosis.
Kenzaka T, Ueda Y.Skin rash in a patient with infectious mononucleosis.BMJ Case Rep.2013 Jul 25;2013:bcr2013010236. doi:10.1136/bcr-2013-010236
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
