Practicing family physicians from the UNC Department of Family Medicine have teamed up with The Carrboro Citizen to bring you a weekly feature responding to your questions about health and medicine. Send your questions or comments to yourhealth@unc.edu
This week we respond to questions about mononucleosis and burning with urination.
Dear HOUSE Calls, I was told by my doctor that I have mono. I saw her because I was fatigued. I had a mono test that was positive, but I have not had fever or sore throat. Do I really have mono?
When we refer to “mono,†we are generally referring to a set of conditions with common clinical features. The most common cause of mono in adolescents and young adults is Ebstein Barr Virus, or EBV. We used to call this the “kissing disease.†The hallmarks of mono are fever, sore throat and swollen lymph nodes. After recovery from the acute infection, fatigue can last for weeks or longer. This is probably why your doctor checked you for mono. It would be unlikely to have had mono without at least some of the hallmark symptoms. However, there is a test known as the mono-spot test, which is a simple positive or negative test that usually remains positive for many years after infection. There are specific antibody titers that can show more recent or past infections with somewhat more clarity. It is also important that you and your doctor keep in mind that there are hundreds of causes of fatigue – anemia, sleep apnea, depression, diabetes and thyroid conditions, to name a few. Based on the little information we have, we think you might not have mono. If you are not feeling better, go back and see your doctor.
Dear HOUSE Calls, I went to the doctor recently with burning when I urinate. My urinalysis came back negative for a urinary tract infection (UTI). What do I have?
Usually a UTI is fairly easy to diagnose from a urinalysis. Occasionally, the tests are indeterminate and a urine culture helps us to be more certain. However, there are a number of other conditions that can cause burning with urination, including: inflammation from a recent UTI (which your body recovered from without treatment); dehydration; urethritis from sexually transmitted infections (gonorrhea, chlamydia and herpes most commonly); vaginal irritation from yeast infections or bacterial vaginitis; trauma or direct irritation; and interstitial cystitis. If the symptoms persist or recur, go back and see your doctor.
House Calls is a weekly column by Dr. Adam Goldstein, Dr. Cristy Page and Dr. Adam Zolotor on behalf of Your Health and the UNC Department of Family Medicine.